Chronic Myelopathies Associated With Human T-Lymphotropic Virus Type I

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Abstract
• Chronic myelopathy associated with human T-lymphotropic virus type I (HTLVI) has been described in HTLV-I endemic areas. In Paris, 167 neurologic patients were screened for HTLV-I by enzymelinked immunosorbent, indirect immunofluorescent, and Western blot assays. Ten of the 11 patients with positive results had a chronic spastic paraparesis with IgG oligoclonal bands and elevated HTLV-I antibody index. Two of them had been born and were living in France, without HTLV-I risk factors. Evoked potentials were abnormal in the nine tested patients and brain magnetic resonance images in three of seven patients. No improvement was observed with steroid treatment. A retrovirus similar to HTLV-I was isolated in five cases at different periods of the disease. Hypotheses of limited endemic areas in western countries are discussed. Early presence and persistence of HTLV-I suggest that it is the etiologic agent.