"transverse myelitis (e.g. due to neuromyelitis optica spectrum disorder (NMOSD), post-infectious, etc.) 5"
"Human T-lymphotropic virus-1 (HTLV-1)-associated myelopathy, also known as tropical spastic paraparesis, is primarily seen in Japan, Melanesia and the Caribbean, and presents with chronic spastic paraparesis."
"This condition has been independently described in Japan (HTLV-1 associated myelopathy) and in the Caribbean (tropical spastic paraparesis), and it is now often referred to by both terms, i.e. HTLV-1-associated myelopathy/tropical spastic paraparesis) 1."
"This condition has been independently described in Japan (HTLV-1 associated myelopathy) and in the Caribbean (tropical spastic paraparesis), and it is now often referred to by both terms, i.e. HTLV-1-associated myelopathy/tropical spastic paraparesis) 1."
"HTLV-1 is only present in some parts of the world, endemic in Japan, and also found in the Caribbean, Melanesia, equatorial Africa, and some parts of Central and South America with an estimated 10-40 million individuals having life-long infection 1,3,4. It is transmitted by blood (transfusion, IVDU) and other bodily fluids (breastfeeding, sexual intercourse) 1,4. Despite its prevalence, only a small fraction (up to 5%) of individuals who are infected ever manifest HTLV-1 related pathology 3."
"HTLV-1 is only present in some parts of the world, endemic in Japan, and also found in the Caribbean, Melanesia, equatorial Africa, and some parts of Central and South America with an estimated 10-40 million individuals having life-long infection 1,3,4. It is transmitted by blood (transfusion, IVDU) and other bodily fluids (breastfeeding, sexual intercourse) 1,4. Despite its prevalence, only a small fraction (up to 5%) of individuals who are infected ever manifest HTLV-1 related pathology 3."
"The most common neurological manifestation of HTLV-1 associated myelopathy is a chronic progressive spastic paraparesis, mainly affecting the lower limbs, with accompanying bowel and bladder dysfunction, and lower back pain 1,4-6. Sensory symptoms, if present, are often subtle, and include loss of vibration and proprioception, and paraesthesias, without a well-defined sensory level 6."
"In addition of myelopathy, HTLV-1 can result in adult T-cell leukaemia, encephalopathy, uveitis, keratoconjunctivitis, myositis, alveolitis and arthropathy 1,3,5."
"It is believed that HTLV-1 associated myelopathy is the result of a multifactorial immune/autoimmune response to infection with the HTLV-1 virus 1. This results in axonal and myelin loss in the cord, particularly in the lateral and posterior columns 5, although the entire cord (including grey matter) demonstrates infiltration with lymphocytes and macrophages 1."
"It is believed that HTLV-1 associated myelopathy is the result of a multifactorial immune/autoimmune response to infection with the HTLV-1 virus 1. This results in axonal and myelin loss in the cord, particularly in the lateral and posterior columns 5, although the entire cord (including grey matter) demonstrates infiltration with lymphocytes and macrophages 1."
"In chronic HTLV-1 associated myelopathy, the most common form, the hallmark radiological feature, if MRI is abnormal, is spinal cord atrophy, particularly affecting the cervicothoracic cord 2,5. This is most pronounced in the lateral and posterior columns 5, mostly involving white matter, but also involving nearby grey matter and anterior nerve roots."
"In acute/subacute phases of HTLV-1 associated myelopathy, there is evidence of longitudinally extensive transverse myelitis, typically in the cervicothoracic cord, with cord swelling and high T2 signal 1,5,8. The cord swelling is often more extensive than the regions of high T2 signal 5. There may be gadolinium contrast enhancement on T1, often dorsolaterally, however, the pattern may be variable (including the trident sign and rarely bright spotty lesions) 1,5,7."
"Human T-lymphotropic virus-1 (HTLV-1)-associated myelopathy, also known as tropical spastic paraparesis, is primarily seen in Japan, Melanesia and the Caribbean, and presents with chronic spastic paraparesis."
"In addition of myelopathy, HTLV-1 can result in adult T-cell leukaemia, encephalopathy, uveitis, keratoconjunctivitis, myositis, alveolitis and arthropathy 1,3,5."
"HTLV-1 is only present in some parts of the world, endemic in Japan, and also found in the Caribbean, Melanesia, equatorial Africa, and some parts of Central and South America with an estimated 10-40 million individuals having life-long infection 1,3,4. It is transmitted by blood (transfusion, IVDU) and other bodily fluids (breastfeeding, sexual intercourse) 1,4. Despite its prevalence, only a small fraction (up to 5%) of individuals who are infected ever manifest HTLV-1 related pathology 3."
"In addition of myelopathy, HTLV-1 can result in adult T-cell leukaemia, encephalopathy, uveitis, keratoconjunctivitis, myositis, alveolitis and arthropathy 1,3,5."
"In chronic HTLV-1 associated myelopathy, the most common form, the hallmark radiological feature, if MRI is abnormal, is spinal cord atrophy, particularly affecting the cervicothoracic cord 2,5. This is most pronounced in the lateral and posterior columns 5, mostly involving white matter, but also involving nearby grey matter and anterior nerve roots."
"No treatment has been shown to consistently alter the disease outcome. The mainstay of treatment is immune modulation, including corticosteroids, interferon-alpha, plasmapheresis, danazol, and pentoxifylline 1,4-6."
"A preceding episode of acute or subacute deterioration (or phase) is reported in a minority of patients 1,5. As such it is felt that there are two phases in some patients; an early acute inflammatory phase and a second chronic phase 1."