Giordano C, Dumas M, Hugon J, Vallat J M, Sonan T, Piquemal M, Akani F, Labrousse F, Denis F
C.H.U. d'Abidjan (Côte d'Ivoire), France.
Rev Neurol (Paris). 1988;144(10):578-85.
Sixty one cases of tropical myeloneuropathies (TNM) from Abidjan, Ivory Coast, are reported. The mean age of patients was 35 years. The socioeconomic level was often very low and puerperality was a common initiating factor. Several clinical forms are noted: pure pyramidal (16 cases), pure ataxic (11 cases), sensory motor polyneuritis (8 cases), combined sclerosis of the spinal cord (1 case), ataxic polyneuritis (25 cases). In fact the extent of the pathobiological process was more severe as shown by slowings of peripheral motor nerve conduction velocities, prolonged central conduction time determined after cortical and spinal stimulations, and a severe sensory axonal impairment on nerve biopsies. These changes were observed with varying degrees in all clinical forms. As long as the etiological factors of TMN are not known (preventing from the possibility to split this disease in several entities) it is preferable to speak about one global disorder and not isolated various clinical forms (e.g. particulary: tropical spastic paraplegia). HTLV-I retrovirus seems to play a limited role in the etiology of TMN in Ivory Coast (1 positive case).
报告了来自科特迪瓦阿比让的61例热带脊髓神经病(TNM)病例。患者的平均年龄为35岁。社会经济水平通常很低,产褥期是常见的始发因素。记录了几种临床类型:单纯锥体束型(16例)、单纯共济失调型(11例)、感觉运动性多神经炎(8例)、脊髓联合硬化症(1例)、共济失调性多神经炎(25例)。事实上,病理生物学过程的程度更为严重,表现为外周运动神经传导速度减慢、皮层和脊髓刺激后测定的中枢传导时间延长,以及神经活检显示严重的感觉轴突损伤。在所有临床类型中均观察到不同程度的这些变化。由于TMN的病因尚不清楚(无法将这种疾病分为几个不同实体),最好将其视为一种全身性疾病,而非孤立的各种临床类型(例如:热带痉挛性截瘫)。在科特迪瓦,HTLV-I逆转录病毒在TMN病因中似乎作用有限(1例阳性)。