ABSTRACT
Two patients from Puerto Rico with progressive paraparesis had serum positive for human T lymphotropic virus type I (HTLV-I) antibodies by ELISA and Western blot, and one patient had HTLV-I antibodies in CSF by the ELISA method. Although the Caribbean basin is considered to be an endemic area for tropical spastic paraparesis, this is the first report of the isolation of HTLV-I antibodies in the serum and CSF of patients with chronic myelopathies in Puerto Rico.
Subject(s)
HTLV-I Antibodies/analysis , Paraparesis, Tropical Spastic/epidemiology , Humans , Male , Middle Aged , Paraparesis, Tropical Spastic/immunology , Puerto Rico/epidemiologyABSTRACT
The development of neurologic deficits confined to the corticospinal tracts has been referred as Primary Lateral Sclerosis (PLS). Through the years, this diagnosis has remained uncertain. In this study we describe seven patients with chronic involvement of the pyramidal system. Two of these patients had serologic evidence of human T-lymphotrophic virus type I infection, one patient had multiple sclerosis and in four patients the clinical diagnosis of PLS was made. The clinical characteristics and diagnostic studies of these patients are presented. A review of the literature with emphasis in the differential diagnosis and a proposed workup for patients with chronic spastic paraparesis are made. This study provides supporting evidence in favor of the clinical entity of PLS.
Subject(s)
Amyotrophic Lateral Sclerosis/diagnosis , Paraparesis, Tropical Spastic/complications , Adult , Aged , Amyotrophic Lateral Sclerosis/complications , Chronic Disease , Diagnosis, Differential , Humans , Middle AgedABSTRACT
La aparición de signos neurológicos confinados al tracto piramidal se conoce como esclerosis lateral primaria. A través de los años, este diagnóstico ha sido cuestionado. En este estudio se describen siete pacientes con daño crónico del sistema piramidal. Dos de estos pacientes tenían evidencia serológica de infección con el virus humano T-linfotrópico tipo I. Un paciente tenía esclerosis múltiple y en cuatro pacientes el diagnóstico de esclerosis lateral primaria fue hecho. Las características clínicas y estudios diagnósticos de estos pacientes son presentados, incluyendo una revisión de la literatura con énfasis en el diagnóstico diferencial de paraparesis espática crónica. Este estudio provee evidencia a favor del diagnóstico de esclerosis lateral primaria como una entidad clínica