Paraparesia espástica tropical nos trópicos e Brasil: análise histórica

Castro-Costa, Carlos Maurício de; Carton, Herwig; Goubau, Patrick; Figueiredo, Eberval Gadelha de; Giffoni, Silvyo David A.

doi:10.1590/S0004-282X1994000100022

Resumos

A paraparesia espástica tropical (PET) é mielopatia crônica, observada predominantemente nos trópicos, recentemente descoberta ser de origem retroviral (HTLV-I). O objetivo deste estudo foi delinear a evolução histórica da sua descrição, denominações e referências etiológicas. A análise histórica revelou que essa condição teve diferentes denominações e a descoberta de sua etiologia retroviral em parte dos casos abriu diversas linhas de investigações e interesse epidemiológico, nos trópicos e no Brasil.

paraparesia espástica tropical; HTLV-I; evolução histórica; perspectivas; Brasil

The tropical spastic paraparesis (TSP) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (HTLV-I). This paper aims at delineating the clinico-etiological evolution of this entity. The historical analysis of it showed that the TSP has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and Brazil.

tropical spastic paraparesis; HTLV-I; historical evolution; perspectives; Brazil

Paraparesia espástica tropical nos trópicos e Brasil: análise histórica

Tropical spastic paraparesis in the tropics and in Brazil: historical analysis

Carlos Maurício de Castro-Costa^I; Herwig Carton^II; Patrick Goubau^III; Eberval Gadelha de Figueiredo^I; Silvyo David A. Giffoni^I

^IServiço de Neurologia, Hospital Universitário Walter Cantídio, Laboratório de Neurologia Experimental, Universidade Federal do Ceará (UFCE)

^IIDepart Neurology, Katholieke Universiteit Leuven, Belgium

^IIIDepart Virology, Katholieke Universiteit Leuven, Belgium

RESUMO

A paraparesia espástica tropical (PET) é mielopatia crônica, observada predominantemente nos trópicos, recentemente descoberta ser de origem retroviral (HTLV-I). O objetivo deste estudo foi delinear a evolução histórica da sua descrição, denominações e referências etiológicas. A análise histórica revelou que essa condição teve diferentes denominações e a descoberta de sua etiologia retroviral em parte dos casos abriu diversas linhas de investigações e interesse epidemiológico, nos trópicos e no Brasil.

Palavras-chave: paraparesia espástica tropical, HTLV-I, evolução histórica, perspectivas, Brasil.

SUMMARY

The tropical spastic paraparesis (TSP) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (HTLV-I). This paper aims at delineating the clinico-etiological evolution of this entity. The historical analysis of it showed that the TSP has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and Brazil.

Keywords: tropical spastic paraparesis, HTLV-I, historical evolution, perspectives, Brazil.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 30-agosto-1993.

Dr. Carlos Maurício de Castro-Costa - Laboratório de Neurologia Experimental, Departamento de Fisiologia e Farmacologia, UFCE - Caixa Postal 3157 - 60431-970 Fortaleza CE - Brasil.

1. Araújo AQC, Ali A, Freitas MR, Nascimento O, Dalgleish AG, Rudge P. HTLV-I and paraparesis of obscure origin in Rio de Janeiro, Brasil. Résumés Congrès de Neurologie Tropicale, Limoges, 1991, p 73.
2. Araújo AQC, Ali A, Newell A, Dalgleish AG, Rudge R HTLV-I infection and neurological disease in Rio de Janeiro. J Neurol Neurosurg Psychiatry 1992, 55: 153-155.
3. Bartholemew C, Cleghorn F, Charles W, Raton P, Roberts L, Mahonj J, Jonkey M, Daisley IT. HTLV-I and tropical spastic paraparesis. Lancet 1986, 2: 99-100.
4. Billinghurst JR. Neurological disorders in Uganda. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 191-206.
5. Cartier-Rovirosa L, Mora C, Araya F, Castillo J, Verdugo R, Miller MA et al. HTLV-I positive spastic paraparesis in a temperate zone (Letter). Lancet 1989, 1: 556-557.
6. Castro LHM, Chaves CJ, Callegaro D, Nóbrega JPS, Scaff M. HTLV-I associated myelopathy in Brazil: a preliminary report. Arq Neuropsiquiatr 1989,47:501-502.
7. Charcot JM. Sclérose des cordons latéraux de la moelle epinière chez une femme hystérique atteinte de la contracture permanente des quatres membres. Bull Soc Med Hop (Paris) 1865 (Suppl), 2: 24-42.
8. Colomb H, Dumas M, Girard PL. Neurological disorders in Senegal. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 259-272.
9. Cosnett JE. Unexplained spastic myelopathy. S Afr Med J 1965, 39: 592-595.
10. Cosnett JE. Neurological disease in Natal. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 259-272.
11. Cruickshank EK. A neuropathic syndrome of uncertain origin. West Indian Med J 1956, 5: 147-158.
12. Cruickshank EK, Montgomery RD, Spillane JD. Obscure neurologic disorders in Jamaica. World Neurol 1961, 2: 199-211.
13. De Castro-Costa CM, do Vale OC, Goubau P, Desmyter J, Carton H. HTLV-I and tropical spastic paraparesis in Fortaleza (Northeastern-Brazil). J Trop Geogr Neurol 1991, 1: 45-48.
14. De Castro-Costa CM, Salgueiro MR, Carton H, do Vale OC, de Arruda AM. Tropical spastic paraparesis in northeastern Brazil. Arq Neuropsiquiatr 1989,47:134-138.
15. Delaporte E, Peeters M, Simoni M, Piot P. HTLV-I infection in Western equatorial Africal (Letter). Lancet 1989, 2: 1226.
16. Denny-Brown D. Neurological conditions resulting from prolonged and severe dietary restriction (case reports in prisioners of war and general review). Medicine 1947, 26: 41-113.
17. De-Thé G, Giordano C, Gessain A, Howlett A, Sonan T, Akani F et al. Human retroviruses HTLV-I, HIV-1 and HIV-2 and neurological diseases in some equatorial areas of Africa. J Acquir Immune Defic Syndr 1989, 2: 550-556.
18. Erb WA. Über einen Wenig bekannten spinalen Symptomen-komplex. Klin Wochenschr 1875, 12: 357-359.
19. Gracia F, Reeves WC, Levine PH, Cuevas M, Castillo L, Chavarrlia R et al. Human T-cell lymphotropic virus type I and neurologic disease in Panamá, 1985 and 1986. Arch Neurol 1990, 47: 634-639.
20. Gessain A, Vernant JC, Maurs L, Barin F, Gout O, Calender A, De-Thé G. Antibodies to human T-lymphotropic virus type I in patients with tropical spastic paraparesis. Lancet 1985, 24: 407-410.
21. Gessain A, Francis H, Sonan T, Giordan C, Akani F, Piquemal M, Caudic C, Malone G, Essex M, De-Thé G. HTLV-I and tropical spastic paraparesis in Africa. Lancet 1986, 20: 698.
22. Giordano C, Dumas M, Hugon J, Vallat JM, Sonan T, Piquemal M et al. Neuromyélopathies tropicales africaines: 61 cas étudiés en Côte-d'Ivoire. Rev Neurol (Paris) 1988, 144: 578-585.
23. Goubau P, Carton H, Kazadi K et al. HTLV sero-epidemiology in a central african population with high incidence of tropical spastic paraparesis. Trans R Soc Trop Med Hyg 1990, 84: 577.
24. Grieve S, Jacobson S, Proctor NSF. A nutritional myelopathy occurring in the Bantu on the Witwatersrand. Neurology 1967, 17: 1205-1212.
25. Guedes T, Mesquita SD, Athaéde LJr, Codeceira AJr. Anti-HTLV-I antibodies in CSF of patients with tropical spastic paraparesis: a report of 5 cases. Resumés Congrès Neurologie Tropicale, Limoges, 1991, p 80.
26. Haddock DR. Neurological disorders in Gana. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p. 143-160.
27. Harries JR. Neurological disorders in Kenya. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 207-222.
28. Johnson RT, Griffin DE, Arregui A, Mora C, Gibbs CJJr, Cuba JM, Trelles L, Vaisberg A. Spastic paraparesis and HTLV-I infection in Peru. Ann Neurol 1988, 23 (Suppl): 151-155.
29. Kayembe K, Goubau P, Desmyter J, Vlietinck R, Carton H. A cluster of HTLV-I associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiatry 1990, 53: 4-10.
30. Lemercier G, Jacquin-Cotton L, Colomb H. Myelopathy of "obscure" etiology: nutritional syndrome. Neurology 1971, 21: 185-188.
31. Lucasse C. Le "Kitondgi": une paralysie spastique. Ann Soc Beige Med Trop 1952, 32: 391-394.
32. Mani KS, Mani AJ, Montgomery RD. A spastic paraplegic syndrome in South India. J Neurol Sci 1969, 9: 179-199.
33. Mani KS. Neurological disease in South India. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 78-85.
34. Marie, Pierre. Huitième leçon: Tabes dorsal spasmodique. In Leçons sur les maladies de la moelle. Paris: G. Masson 1892, p 87-96.
35. Marshall J. Spastic paraplegia of middle age: a clinicopathological study. Lancet 1955, 1: 643-646.
36. Meireles A, Moreira EDJr, Moreno-Carvalho OA, Badaró R, Melo A. HTLV-I associated myelopathy in Salvador (Northeastern Brazil). Arq Neuropsiquiatr 1992, 50: 189-190.
37. Montgomery RD, Cruickshank EK, Robertson WB, MacMenemey WH. Clinical and pathological observation on Jamaican neuropathy: a report of 206 cases. Brain 1964, 87: 425-462.
38. Moreno-Carvalho OA, Santos JI, Di Credico G, Galvão-Castro B. Evidence of preferencial female prevalence of HTLV-I associated tropical spastic paraparesis in Bahia, Brazil. Arq Neupsiquiatr 1992, 50: 183-188.
39. Osame M, Usuku K, Izumo S, Ijichi N, Amitani H, Igata A et al. HTLV-I associated myelopathy, a new clinical entity (Letter). Lancet 1986, 1: 1031-1032.
40. Osuntokun BO. Neurological disorders in Nigeria. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 161-190.
41. Pallister RA. Ataxic paraplegia occuring among Chinese in Malaya. Trans R Soc Trop Med Hyg 1940, 34: 203-211.
42. Petit JHS. Spastic paralysis in New Caledonian leprosy patients. In Spillane JD (ed). Tropical neurology, London: Oxford Univ Press 1973, p 333.
43. Poiesz BJ, Ruscetti FM, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Nat Acad Sci (Wash) 1980, 77: 7415-7419.
44. Rodgers-Johnson P, Gajdusek DC, Morgan OSTC, Zaninovic V, Sarin PS, Graham DS. HTLV-I and HTLV-III antibodies and tropical spastic paraparesis. Lancet 1985, 2: 1248-1249.
45. Roman GC, Roman LN, Spencer PS, Schoenberg BS. Tropical spastic paraparesis: a neuroepidemiological study in Colombia. Ann Neurol 1985, 17: 361-365.
46. Roman GC, Schoenberg BS, Madden DL, Sever JL, Hugon J, Rudolph A, Spencer PS. Human T-lymphotropic virus type I antibodies in the serum of patients with tropical spastic paraparesis in the Seychelles. Arch Neurol 1987, 44: 605-607.
47. Roman GS, Osame M. Identity of HTLV-I associated tropical spastic paraparesis and HTLV-I associated myelopathy (Letter). Lancet 1988, 1: 651.
48. Sohler MP, Cavalcanti M, Schechter M, Novis SAP. Neurological disorders associated with HTLV-I in Rio de Janeiro, Brasil. Résumés, Congrès de Neurologie Tropicale, Limoges, 1991, p 70.
49. Spillane JD. Tropical neurology. Oxford Univ Press 1973.
50. Spina-França A, Livramento JA, Machado LR, Gomes HR, Vianna LS, Castro LHM, Nóbrega JPS, Bacheschi LA. HTLV-I antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil. Arq Neuropsiquiatr 1990, 48: 441-447.
51. Takayanagui OM, Cantos JL, Jardim E. Tropical spastic paraparesis in Brazi (Letter). Lancet 1991, 2: 309.
52. Trolli G. Résumé des observations réunies au Kwango au sujet de deux affections d'origine indeterminée: paraplegie spastique épidemique. Bruxelles: Fondation Reine Elizabeth, 1938.
53. Wallace ID, Cosnett JE. Unexplained spastic paraplegia. S Afr Med J 1983, 63: 689-691.
54. Weschler IS, Brody S. The problem of primary lateral sclerosis. JAMA 1946, 130: 1195-1198.
55. Zanicovic V, Biojo R, Barreto P. Paraparesia espástica del Pacífico. Colombia Med 1981, 12: 111-117.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Mar 1994

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

[1] 1. Araújo AQC, Ali A, Freitas MR, Nascimento O, Dalgleish AG, Rudge P. HTLV-I and paraparesis of obscure origin in Rio de Janeiro, Brasil. Résumés Congrès de Neurologie Tropicale, Limoges, 1991, p 73.

[2] 2. Araújo AQC, Ali A, Newell A, Dalgleish AG, Rudge R HTLV-I infection and neurological disease in Rio de Janeiro. J Neurol Neurosurg Psychiatry 1992, 55: 153-155.

[3] 3. Bartholemew C, Cleghorn F, Charles W, Raton P, Roberts L, Mahonj J, Jonkey M, Daisley IT. HTLV-I and tropical spastic paraparesis. Lancet 1986, 2: 99-100.

[4] 4. Billinghurst JR. Neurological disorders in Uganda. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 191-206.

[5] 5. Cartier-Rovirosa L, Mora C, Araya F, Castillo J, Verdugo R, Miller MA et al. HTLV-I positive spastic paraparesis in a temperate zone (Letter). Lancet 1989, 1: 556-557.

[6] 6. Castro LHM, Chaves CJ, Callegaro D, Nóbrega JPS, Scaff M. HTLV-I associated myelopathy in Brazil: a preliminary report. Arq Neuropsiquiatr 1989,47:501-502.

[7] 7. Charcot JM. Sclérose des cordons latéraux de la moelle epinière chez une femme hystérique atteinte de la contracture permanente des quatres membres. Bull Soc Med Hop (Paris) 1865 (Suppl), 2: 24-42.

[8] 8. Colomb H, Dumas M, Girard PL. Neurological disorders in Senegal. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 259-272.

[9] 9. Cosnett JE. Unexplained spastic myelopathy. S Afr Med J 1965, 39: 592-595.

[10] 10. Cosnett JE. Neurological disease in Natal. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 259-272.

[11] 11. Cruickshank EK. A neuropathic syndrome of uncertain origin. West Indian Med J 1956, 5: 147-158.

[12] 12. Cruickshank EK, Montgomery RD, Spillane JD. Obscure neurologic disorders in Jamaica. World Neurol 1961, 2: 199-211.

[13] 13. De Castro-Costa CM, do Vale OC, Goubau P, Desmyter J, Carton H. HTLV-I and tropical spastic paraparesis in Fortaleza (Northeastern-Brazil). J Trop Geogr Neurol 1991, 1: 45-48.

[14] 14. De Castro-Costa CM, Salgueiro MR, Carton H, do Vale OC, de Arruda AM. Tropical spastic paraparesis in northeastern Brazil. Arq Neuropsiquiatr 1989,47:134-138.

[15] 15. Delaporte E, Peeters M, Simoni M, Piot P. HTLV-I infection in Western equatorial Africal (Letter). Lancet 1989, 2: 1226.

[16] 16. Denny-Brown D. Neurological conditions resulting from prolonged and severe dietary restriction (case reports in prisioners of war and general review). Medicine 1947, 26: 41-113.

[17] 17. De-Thé G, Giordano C, Gessain A, Howlett A, Sonan T, Akani F et al. Human retroviruses HTLV-I, HIV-1 and HIV-2 and neurological diseases in some equatorial areas of Africa. J Acquir Immune Defic Syndr 1989, 2: 550-556.

[18] 18. Erb WA. Über einen Wenig bekannten spinalen Symptomen-komplex. Klin Wochenschr 1875, 12: 357-359.

[19] 19. Gracia F, Reeves WC, Levine PH, Cuevas M, Castillo L, Chavarrlia R et al. Human T-cell lymphotropic virus type I and neurologic disease in Panamá, 1985 and 1986. Arch Neurol 1990, 47: 634-639.

[20] 20. Gessain A, Vernant JC, Maurs L, Barin F, Gout O, Calender A, De-Thé G. Antibodies to human T-lymphotropic virus type I in patients with tropical spastic paraparesis. Lancet 1985, 24: 407-410.

[21] 21. Gessain A, Francis H, Sonan T, Giordan C, Akani F, Piquemal M, Caudic C, Malone G, Essex M, De-Thé G. HTLV-I and tropical spastic paraparesis in Africa. Lancet 1986, 20: 698.

[22] 22. Giordano C, Dumas M, Hugon J, Vallat JM, Sonan T, Piquemal M et al. Neuromyélopathies tropicales africaines: 61 cas étudiés en Côte-d'Ivoire. Rev Neurol (Paris) 1988, 144: 578-585.

[23] 23. Goubau P, Carton H, Kazadi K et al. HTLV sero-epidemiology in a central african population with high incidence of tropical spastic paraparesis. Trans R Soc Trop Med Hyg 1990, 84: 577.

[24] 24. Grieve S, Jacobson S, Proctor NSF. A nutritional myelopathy occurring in the Bantu on the Witwatersrand. Neurology 1967, 17: 1205-1212.

[25] 25. Guedes T, Mesquita SD, Athaéde LJr, Codeceira AJr. Anti-HTLV-I antibodies in CSF of patients with tropical spastic paraparesis: a report of 5 cases. Resumés Congrès Neurologie Tropicale, Limoges, 1991, p 80.

[26] 26. Haddock DR. Neurological disorders in Gana. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p. 143-160.

[27] 27. Harries JR. Neurological disorders in Kenya. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 207-222.

[28] 28. Johnson RT, Griffin DE, Arregui A, Mora C, Gibbs CJJr, Cuba JM, Trelles L, Vaisberg A. Spastic paraparesis and HTLV-I infection in Peru. Ann Neurol 1988, 23 (Suppl): 151-155.

[29] 29. Kayembe K, Goubau P, Desmyter J, Vlietinck R, Carton H. A cluster of HTLV-I associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiatry 1990, 53: 4-10.

[30] 30. Lemercier G, Jacquin-Cotton L, Colomb H. Myelopathy of "obscure" etiology: nutritional syndrome. Neurology 1971, 21: 185-188.

[31] 31. Lucasse C. Le "Kitondgi": une paralysie spastique. Ann Soc Beige Med Trop 1952, 32: 391-394.

[32] 32. Mani KS, Mani AJ, Montgomery RD. A spastic paraplegic syndrome in South India. J Neurol Sci 1969, 9: 179-199.

[33] 33. Mani KS. Neurological disease in South India. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 78-85.

[34] 34. Marie, Pierre. Huitième leçon: Tabes dorsal spasmodique. In Leçons sur les maladies de la moelle. Paris: G. Masson 1892, p 87-96.

[35] 35. Marshall J. Spastic paraplegia of middle age: a clinicopathological study. Lancet 1955, 1: 643-646.

[36] 36. Meireles A, Moreira EDJr, Moreno-Carvalho OA, Badaró R, Melo A. HTLV-I associated myelopathy in Salvador (Northeastern Brazil). Arq Neuropsiquiatr 1992, 50: 189-190.

[37] 37. Montgomery RD, Cruickshank EK, Robertson WB, MacMenemey WH. Clinical and pathological observation on Jamaican neuropathy: a report of 206 cases. Brain 1964, 87: 425-462.

[38] 38. Moreno-Carvalho OA, Santos JI, Di Credico G, Galvão-Castro B. Evidence of preferencial female prevalence of HTLV-I associated tropical spastic paraparesis in Bahia, Brazil. Arq Neupsiquiatr 1992, 50: 183-188.

[39] 39. Osame M, Usuku K, Izumo S, Ijichi N, Amitani H, Igata A et al. HTLV-I associated myelopathy, a new clinical entity (Letter). Lancet 1986, 1: 1031-1032.

[40] 40. Osuntokun BO. Neurological disorders in Nigeria. In Spillane JD (ed). Tropical neurology. London: Oxford Univ Press 1973, p 161-190.

[41] 41. Pallister RA. Ataxic paraplegia occuring among Chinese in Malaya. Trans R Soc Trop Med Hyg 1940, 34: 203-211.

[42] 42. Petit JHS. Spastic paralysis in New Caledonian leprosy patients. In Spillane JD (ed). Tropical neurology, London: Oxford Univ Press 1973, p 333.

[43] 43. Poiesz BJ, Ruscetti FM, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Nat Acad Sci (Wash) 1980, 77: 7415-7419.

[44] 44. Rodgers-Johnson P, Gajdusek DC, Morgan OSTC, Zaninovic V, Sarin PS, Graham DS. HTLV-I and HTLV-III antibodies and tropical spastic paraparesis. Lancet 1985, 2: 1248-1249.

[45] 45. Roman GC, Roman LN, Spencer PS, Schoenberg BS. Tropical spastic paraparesis: a neuroepidemiological study in Colombia. Ann Neurol 1985, 17: 361-365.

[46] 46. Roman GC, Schoenberg BS, Madden DL, Sever JL, Hugon J, Rudolph A, Spencer PS. Human T-lymphotropic virus type I antibodies in the serum of patients with tropical spastic paraparesis in the Seychelles. Arch Neurol 1987, 44: 605-607.

[47] 47. Roman GS, Osame M. Identity of HTLV-I associated tropical spastic paraparesis and HTLV-I associated myelopathy (Letter). Lancet 1988, 1: 651.

[48] 48. Sohler MP, Cavalcanti M, Schechter M, Novis SAP. Neurological disorders associated with HTLV-I in Rio de Janeiro, Brasil. Résumés, Congrès de Neurologie Tropicale, Limoges, 1991, p 70.

[49] 49. Spillane JD. Tropical neurology. Oxford Univ Press 1973.

[50] 50. Spina-França A, Livramento JA, Machado LR, Gomes HR, Vianna LS, Castro LHM, Nóbrega JPS, Bacheschi LA. HTLV-I antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil. Arq Neuropsiquiatr 1990, 48: 441-447.

[51] 51. Takayanagui OM, Cantos JL, Jardim E. Tropical spastic paraparesis in Brazi (Letter). Lancet 1991, 2: 309.

[52] 52. Trolli G. Résumé des observations réunies au Kwango au sujet de deux affections d'origine indeterminée: paraplegie spastique épidemique. Bruxelles: Fondation Reine Elizabeth, 1938.

[53] 53. Wallace ID, Cosnett JE. Unexplained spastic paraplegia. S Afr Med J 1983, 63: 689-691.

[54] 54. Weschler IS, Brody S. The problem of primary lateral sclerosis. JAMA 1946, 130: 1195-1198.

[55] 55. Zanicovic V, Biojo R, Barreto P. Paraparesia espástica del Pacífico. Colombia Med 1981, 12: 111-117.