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      Paraparesia espástica tropical / mielopatia associada ao HTLV-I: relato de dois casos diagnosticados em Florianópolis, Santa Catarina Translated title: HTLV-I associated myelopathy/ tropical spastic paraparesis: report of two cases diagnosed in Florianópolis, Santa Catarina - Brazil

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          Abstract

          Descrevemos dois casos clínicos de paraparesia espástica tropical / mielopatia associada ao HTLV-I (PET/MAH), segundo os critérios da OMS-1989. Estes são os primeiros casos diagnosticados em Florianópolis (SC-Brasil). Em um dos casos houve resposta clínica ao uso de metilprednisolona.

          Translated abstract

          We describe two cases of tropical spastic paraparesis / HTLV-1 associated myelopathy, according to the criteria of World Health Organization-1989. These are the first cases diagnosed in Florianópolis (Santa Catarina State - Brazil). One of them had a good response with the treatment with methylprednisolone.

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          Clinical and demographic features of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Rio de Janeiro, Brazil.

          Eduardo Alfonso, Alexandra P Q C Araújo, D Schor … (1993)
          In Rio de Janeiro (RJ) most cases of paraparesis of obscure origin are associated with the human T-cell lymphotropic virus type I (HTLV-I). Thirty-four consecutive patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) from RJ were evaluated. Most patients came from low socio-economic levels. There was no difference in terms of gender. The main affected racial group was white. A history of sexually transmitted diseases was a major risk factor for HAM/TSP and a positive serology for syphilis was found in 26.5% of the patients. The major clinical findings were of a spastic paraparesis with generalized brisk tendon jerks and bilateral Babinki's sign. Sensation was abnormal in 25 patients (73.5%) and five (14.7%) had a sensory level. Three patients (8.8%) had optic atrophy. The cerebrospinal fluid showed a lymphocytic pleocytosis with a mean total protein content of 0.4 g/litre, and an increased intrathecal IgG synthesis in 59.4% of patients. HAM/TSP and multiple sclerosis (MS) occur indigenously in RJ and some HAM/TSP cases can be sometimes confused with MS. Therefore we propose that, in places where MS coexist with HAM/TSP, HTLV-I antibodies should be sought routinely in those MS suspected cases with prominent spastic paraparesis.
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            HTLV-1 antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil

            A. Spina-França, J. Livramento, L. Machado … (1990)
            HTLV-l antibodies were investigated in serum and in CSF of 150 patients with neurologic disorders mainly myelopathies. The patients were considered into three groups according to the possible relationship of their disease to the presence of HTLV-l antibodies: no relationship risk (control group), occasional risk group, and possible risk group. In this latter are 56 patients with crural spastic paraparesis or paraplegia of unknown etiology (SP). HTLV-l antibodies were tested by the passive particle-agglutination method for anti-ATLA antibody detection. The search was negative in all patients of the control group, and positive (serum and/or CSF) in 16.5% of the patients from the second group and in 55.4% of the SP patients group. Clinical patterns in SP cases with HTLV-l antibodies were those of tropical spastic paraparesis (TSP). CSF patterns considered (cytology, protein content and gamma-globulins rate) were different between TSP group with HTLV-l antibodies in CSF and SP group with no HTLV-l antibodies detection either in serum or in CSF. The difference was significant. Results of this investigation confirm the high incidence of TSP in Brazil, and bring additional indication for searching HTLV-l antibodies in the CSF.
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              Tropical spastic paraparesis in Northeastern Brazil

              C. Costa, M. R. Salgueiro, H Carton … (1989)
              Ten possible cases of tropical spastic paraparesis (TSP) in Northeastern Brazil (Ceará) are presented. They show the typical symptoms and signs of TSP consisting of weakness of the lower limbs, spastic gait, hiperreflexia, bladder dysfunction and variable signs of posterior columns impairment. The laboratory examinations excluded other compressive, infective, degenerative or demyelinating lesions of their spinal cord. Our patients age ranged from 21 to 59 years, all were of black origin and all were of lower social class. There was a slight preponderance of females. An etiological implication of a retrovirus (HTLV-I) has been shown for TSP, but for lack of technical conditions we could not determine it in our patients, and that stands as our subsequent step in those and further cases.
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                Author and article information

                Journal
                Journal ID (publisher-id): anp
                Title: Arquivos de Neuro-Psiquiatria
                Abbreviated Title: Arq. Neuro-Psiquiatr.
                Publisher: Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )
                ISSN (Print): 0004-282X
                ISSN (Electronic): 1678-4227
                Publication date (Print and electronic): March 1998
                Volume: 56
                Issue: 1
                Pages: 120-122
                Affiliations
                [02] orgnameHospital Governador Celso Ramos orgdiv1Programa de Residência em Neurologia
                [01] Florianópolis SC orgnameHospital Governador Celso Ramos orgdiv1Serviço de Neurologia
                Article
                Publisher ID: S0004-282X1998000100020 Publisher ID: S0004-282X(98)05600120
                DOI: 10.1590/S0004-282X1998000100020
                SO-VID: 1448ef19-8551-4bc7-b527-3ba8eb739b6c
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Date accepted : 15 October 1997
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 3
                Product

                SciELO Brazil


                Keywords: diagnosis,HTLV-1,tropical spastic paraparesis,metilprednisolona,diagnóstico,paraparesia espástica tropical,methylprednisolone
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                Keywords: diagnosis, HTLV-1, tropical spastic paraparesis, metilprednisolona, diagnóstico, paraparesia espástica tropical, methylprednisolone

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