Familial Spastic Paraparesis Syndrome Associated with HTLV-I Infection

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Abstract
HUMAN T-cell lymphotropic virus Type I (HTLV-I) is a retrovirus identified as the etiologic agent of adult T-cell leukemia and lymphoma.1 , 2 More recently, HTLV-I infection has been implicated in the causation of chronic progressive myelopathies, such as tropical spastic paraparesis3 , 4 and HTLV-I—associated myelopathy.5 HTLV-I—associated myelopathy affects patients from southern Japan, which has a temperate climate, whereas tropical spastic paraparesis affects persons from tropical areas. Despite these differences, the two conditions resemble each other,6 prompting some to suggest that they are different names for the same disease.7 HTLV-I has been implicated in the development of these conditions, because affected persons have serum5 , 8 , 9 and intrathecally synthesized4 , 10 anti—HTLV-I antibodies, as well as evidence of cerebrospinal fluid oligoclonal bands with antibody activity directed against HTLV-I p24.11 In addition, HTLV-I has been isolated from the serum and cerebrospinal fluid of patients with tropical spastic paraparesis or HTLV-I—associated myelopathy.12 , 13

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