Ogata A, Nagashima K, Tashiro K, Miyakawa A, Mikuni C
Department of Neurology, Hokkaido University School of Medicine, Sapporo, Japan.
J Neurol Neurosurg Psychiatry. 1993 Feb;56(2):194-6. doi: 10.1136/jnnp.56.2.194.
A postmortem case of HTLV-I associated myelopathy (HAM)/tropical spastic paraparesis (TSP) with a history of remission and exacerbation of neurological signs and symptoms, resembling those of multiple sclerosis is reported. MRI analysis revealed lesions in the periventricular white matter in addition to atrophy of the thoracic spinal cord, characteristic of HAM/TSP. The cerebral periventricular areas consisted of ill-defined paucity of myelin sheaths with astrocytic gliosis and hyaline thickening of blood vessels. The poorly demarcated white matter lesions found in both brain and spinal cord were different from plaques found in multiple sclerosis. It is suggested that, in some cases of HAM/TSP, inflammatory lesions that destroy myelin can involve not only the spinal cord but also the cerebral periventricular white matter.
报告了一例人嗜T淋巴细胞病毒I型（HTLV-I）相关脊髓病（HAM）/热带痉挛性截瘫（TSP）的尸检病例，该病例有神经体征和症状缓解与加重的病史，类似于多发性硬化症。MRI分析显示，除胸段脊髓萎缩外，脑室周围白质也有病变，这是HAM/TSP的特征。脑室内周围区域表现为髓鞘模糊稀疏，伴有星形细胞胶质增生和血管透明样增厚。在脑和脊髓中发现的界限不清的白质病变与多发性硬化症中的斑块不同。提示在某些HAM/TSP病例中，破坏髓鞘的炎性病变不仅可累及脊髓，还可累及脑室周围脑白质。
