Tropical spastic paraparesis in Northeastern Brazil

Costa, C. M. de Castro; Salgueiro, M. R.; Carton, H.; Vale, O. C. do; Arruda, A. M. de

doi:10.1590/S0004-282X1989000200002

Abstracts

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.

Os autores apresentam 10 casos de provável paraparesia espástica tropical (PET) oriundos do Nordeste do Brasil (Hospital das Clínicas - Universidade Federal do Ceará). Os sintomas consistem de fraqueza dos membros inferiores, marcha espástica, hiperreflexia, disfunção esfincteriana e sinais variados de distúrbio proprioceptivo. Outras etiologias de mielopatias foram excluídas pelos exames complementares. A idade dos pacientes ia de 21 a 59 anos, todos eram da raça negra e havia discreto predomínio de mulheres. Recentemente, tem-se atribuído ao retrovírus HTLV-I a etiologia da PET. Por falta de condições técnicas ainda não pudemos determiná-la em nossos pacientes.

Tropical spastic paraparesis in Northeastern Brazil

Paraparesia espástica tropical no Nordeste do Brasil

C. M. de Castro Costa^I; M. R. Salgueiro^II; H. Carton^III; O. C. do Vale^II; A. M. de Arruda^II

^IDepartment of Physiology and Service of Neurology, University Hospital, Federal University of Ceara (UH, FUC), Brazil

^IIService of Neurology, UH, FUC

^IIIDepartment of Neurology, Catholique University of Louvain, Belgium

SUMMARY

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.

RESUMO

Os autores apresentam 10 casos de provável paraparesia espástica tropical (PET) oriundos do Nordeste do Brasil (Hospital das Clínicas - Universidade Federal do Ceará). Os sintomas consistem de fraqueza dos membros inferiores, marcha espástica, hiperreflexia, disfunção esfincteriana e sinais variados de distúrbio proprioceptivo. Outras etiologias de mielopatias foram excluídas pelos exames complementares. A idade dos pacientes ia de 21 a 59 anos, todos eram da raça negra e havia discreto predomínio de mulheres. Recentemente, tem-se atribuído ao retrovírus HTLV-I a etiologia da PET. Por falta de condições técnicas ainda não pudemos determiná-la em nossos pacientes.

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Dr. C. M. Castro Costa - Departamento de Fisiologia e Farmacologia - Centro de Ciências da Saúde, Universidade Federal do Ceará - Caixa Postal 657 - 60000 Fortaleza CE - Brasil.

1. Carton H, Kayembe K, Kabeya N, Odio, Biliau A, Maertens K - Epidemic spastic paraparesis in Bandundu (Zaire). J Neurol Neurosurg Psychiat 49:620, 1986.
2. Cosnett JE - Unexplained spastic myelopathy: 41 cases in a non-european hospital. S Afr Med J 39:592, 1965.
3. Cruickshank EK - A neuropathic syndrome of uncertain origin. West Indian Med J 5:147, 1956.
4. Galvão ACR - Radiculomielopatias esquistossomóticas. Arq Bras Neurocirurg 1:133, 1985.
5. Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A, de-Thé G - Antibodies to human T-Lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet 2:407, 1985.
6. Gessain A, Francis H, Sonan T, Giordano C, Akani F, Piquemal M, Claudie C, Malone G, Essex M, de-Thé G - HTLV-I and tropical spastic paraparesis in Africa. Lancet 2:698, 1986.
7. Johnson RT, Griffin DE, Arregui A, Mora C, Gibbs CJ, Cuba JM, Trelles L, Vaisberg A - Spastic paraparesis and HTLV-I infection in Peru. Ann Neurol 23 (suppl): S.151, 1988.
8. Kelly R, De Mol B - Paraplegia in the islands of the Indian Ocean. Afr J Neurol Sci 1:5, 1982.
9. Mani KS - Neurological disease in South India. In Spillane JD (ed): Tropical Neurology. Oxford University Press, London, 1973, pg 78.
10. Mani KS, Mani AJ, Montgomery RD - A spastic paraplegic syndrome in South India. J Neurol Sci 9:179, 1969.
11. Picardo P, Ceroni M, Rodgers-Johnson P, Mora C, Ascher DM, Char G, Gibbs CJ and Gajdusek DC - Pathological and immunological observations on tropical spastic paraparesis in patients from Jamaica. Ann Neurol 23 (suppl): S.156, 1988.
12. Roman GC - The neuroepidemiology of tropical spastic paraparesis. Ann Neurol 23 (suppl): S.113, 1988.
13. Roman GC, Spencer PS, Schoenberg BS, Hugon J, Ludolph A, Rodgers-Johnson P, Osuntokun BO, Shamlaye CF - Tropical spastic paraparesis in the Seychelles islands: a clinical and case-control neuroepidemiological study. Neurology 37:1323, 1987.
14. Roman GC, Spencer PS, Schoenberg BS - Tropical myeloneuropathies: the hidden endemias. Neurology 35:1158, 1985.
15. Roman GC, Roman LN, Spencer PS, Schoenberg BS - An outbreak of spastic paraparesis along the southern Pacific coast of Colombia: clinical and epidemiological features. Ann Neurol 14:152, 1983.
16. Roman GC, Roman LN, Spencer PS, Schoenberg BS - Tropical spastic paraparesis: a neuroepidemiological study in Colombia. Ann Neurol 17:361, 1985.
17. Rodgers-Johnson P, Gajdusek DC, Morgan O S:t C, Zaninovic V, Sarin FS, Graham DS - HTLV-1 and HTLV-III antibodies and tropical spastic paraparesis. Lancet 2:1247, 1985.
18. Scott HH - An investigation into an acute outbreak of central neuritis. Ann Trop Med Parasitol 12:109, 1918.
19. Spillane JD - Tropical Neurology. Oxford University Press, London, 1973.
20. Strachan H - On a form of multiple neuritis prevalent in the West Indies. Practitioner 59:477, 1897.
21. Vernant JC, Gessain A, Gout O, Maurs L, Buisson G, Barin F, Calender A, de-Thé G - Paraparésies spastiques tropicales en Martinique: haute prévalence d'anticorps HTLV-I. Presse Med 15:419, 1986.
22. Vernant JC, Maurs L, Gessain A, Barin F, Gout O, Delaporte JM, Sanhadji K, Buisson G, de-Thé G - Endemic tropical spastic paraparesis associated with human T-lymphotropic virus type-I: a clinical and sero-epidemiological study of cases. Ann Neurol 21: 123, 1987.
23. Zaninovic V, Biojó R, Barreto P - Paraparesia espástica del Pacífico. Colombia Med 12:111, 1981.

Publication Dates

Publication in this collection
06 June 2011
Date of issue
June 1989

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

[1] 1. Carton H, Kayembe K, Kabeya N, Odio, Biliau A, Maertens K - Epidemic spastic paraparesis in Bandundu (Zaire). J Neurol Neurosurg Psychiat 49:620, 1986.

[2] 2. Cosnett JE - Unexplained spastic myelopathy: 41 cases in a non-european hospital. S Afr Med J 39:592, 1965.

[3] 3. Cruickshank EK - A neuropathic syndrome of uncertain origin. West Indian Med J 5:147, 1956.

[4] 4. Galvão ACR - Radiculomielopatias esquistossomóticas. Arq Bras Neurocirurg 1:133, 1985.

[5] 5. Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A, de-Thé G - Antibodies to human T-Lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet 2:407, 1985.

[6] 6. Gessain A, Francis H, Sonan T, Giordano C, Akani F, Piquemal M, Claudie C, Malone G, Essex M, de-Thé G - HTLV-I and tropical spastic paraparesis in Africa. Lancet 2:698, 1986.

[7] 7. Johnson RT, Griffin DE, Arregui A, Mora C, Gibbs CJ, Cuba JM, Trelles L, Vaisberg A - Spastic paraparesis and HTLV-I infection in Peru. Ann Neurol 23 (suppl): S.151, 1988.

[8] 8. Kelly R, De Mol B - Paraplegia in the islands of the Indian Ocean. Afr J Neurol Sci 1:5, 1982.

[9] 9. Mani KS - Neurological disease in South India. In Spillane JD (ed): Tropical Neurology. Oxford University Press, London, 1973, pg 78.

[10] 10. Mani KS, Mani AJ, Montgomery RD - A spastic paraplegic syndrome in South India. J Neurol Sci 9:179, 1969.

[11] 11. Picardo P, Ceroni M, Rodgers-Johnson P, Mora C, Ascher DM, Char G, Gibbs CJ and Gajdusek DC - Pathological and immunological observations on tropical spastic paraparesis in patients from Jamaica. Ann Neurol 23 (suppl): S.156, 1988.

[12] 12. Roman GC - The neuroepidemiology of tropical spastic paraparesis. Ann Neurol 23 (suppl): S.113, 1988.

[13] 13. Roman GC, Spencer PS, Schoenberg BS, Hugon J, Ludolph A, Rodgers-Johnson P, Osuntokun BO, Shamlaye CF - Tropical spastic paraparesis in the Seychelles islands: a clinical and case-control neuroepidemiological study. Neurology 37:1323, 1987.

[14] 14. Roman GC, Spencer PS, Schoenberg BS - Tropical myeloneuropathies: the hidden endemias. Neurology 35:1158, 1985.

[15] 15. Roman GC, Roman LN, Spencer PS, Schoenberg BS - An outbreak of spastic paraparesis along the southern Pacific coast of Colombia: clinical and epidemiological features. Ann Neurol 14:152, 1983.

[16] 16. Roman GC, Roman LN, Spencer PS, Schoenberg BS - Tropical spastic paraparesis: a neuroepidemiological study in Colombia. Ann Neurol 17:361, 1985.

[17] 17. Rodgers-Johnson P, Gajdusek DC, Morgan O S:t C, Zaninovic V, Sarin FS, Graham DS - HTLV-1 and HTLV-III antibodies and tropical spastic paraparesis. Lancet 2:1247, 1985.

[18] 18. Scott HH - An investigation into an acute outbreak of central neuritis. Ann Trop Med Parasitol 12:109, 1918.

[19] 19. Spillane JD - Tropical Neurology. Oxford University Press, London, 1973.

[20] 20. Strachan H - On a form of multiple neuritis prevalent in the West Indies. Practitioner 59:477, 1897.

[21] 21. Vernant JC, Gessain A, Gout O, Maurs L, Buisson G, Barin F, Calender A, de-Thé G - Paraparésies spastiques tropicales en Martinique: haute prévalence d'anticorps HTLV-I. Presse Med 15:419, 1986.

[22] 22. Vernant JC, Maurs L, Gessain A, Barin F, Gout O, Delaporte JM, Sanhadji K, Buisson G, de-Thé G - Endemic tropical spastic paraparesis associated with human T-lymphotropic virus type-I: a clinical and sero-epidemiological study of cases. Ann Neurol 21: 123, 1987.

[23] 23. Zaninovic V, Biojó R, Barreto P - Paraparesia espástica del Pacífico. Colombia Med 12:111, 1981.