Progression of neurological disability in HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). 1995

A Q Araújo, and A C Leite, and S V Dultra, and M J Andrada-Serpa
HTLV-Associated Neuropathies Research Unit, IOC, Hospital Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.

HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is apparently a disease with a chronic evolution without spontaneous remissions. The real profile of its natural history and of the progression of the neurological disability, however, awaits confirmation. We devised the present study to evaluate the progression profile of the neurological disability of HAM/TSP in a series of 43 patients who have never received any kind of previous immune therapy. Patients were divided into different groups according to the duration of their disease. Age, gender and the Kurtzke's disability status scale (DSS) at the time of the first examination were compared. There were no statistically significant differences among groups with different disease duration. The present study suggests that the evolution of the neurological disability in HAM/TSP occurs mainly during the first year of the disease and becomes relatively stable after that. Therefore we speculate that the variable therapeutic success rates observed in many series of the literature could be due to the timing in the beginning of the pharmacological immunosuppression. Probably the therapeutic window in HAM/TSP lies within the first year of the disease. Thus it might be of utmost importance that future therapeutical trials take into consideration the duration of the disease since this factor can play an important role in the results of the trial.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D015493 Paraparesis, Tropical Spastic A subacute paralytic myeloneuropathy occurring endemically in tropical areas such as the Caribbean, Colombia, India, and Africa, as well as in the southwestern region of Japan; associated with infection by HUMAN T-CELL LEUKEMIA VIRUS I. Clinical manifestations include a slowly progressive spastic weakness of the legs, increased reflexes, Babinski signs, incontinence, and loss of vibratory and position sensation. On pathologic examination inflammatory, demyelination, and necrotic lesions may be found in the spinal cord. (Adams et al., Principles of Neurology, 6th ed, p1239) HTLV-I-Associated Myelopathy,Tropical Spastic Paraparesis,Familial Spastic Paraparesis, Htlv-1-Associated,HTLV I Associated Myelopathies,HTLV-I-Associated Myelopathy-Tropical Spastic Paraparesis,Human T-Lymphotropic Virus Type 1 Associated Myelopathy,Myelopathies, HTLV I Associated,Myelopathy, Htlv-1-Associated,Myelopathy, Human T-Lymphotropic Virus Type 1 Associated,Paraplegia, Tropical Spastic,Familial Spastic Paraparesis, Htlv 1 Associated,HTLV I Associated Myelopathy,HTLV I Associated Myelopathy Tropical Spastic Paraparesis,HTLV-I-Associated Myelopathies,Htlv-1-Associated Myelopathies,Htlv-1-Associated Myelopathy,Human T Lymphotropic Virus Type 1 Associated Myelopathy,Myelopathies, HTLV-I-Associated,Myelopathies, Htlv-1-Associated,Myelopathy, HTLV-I-Associated,Myelopathy, Htlv 1 Associated,Myelopathy, Human T Lymphotropic Virus Type 1 Associated,Parapareses, Tropical Spastic,Paraplegias, Tropical Spastic,Spastic Parapareses, Tropical,Spastic Paraparesis, Tropical,Spastic Paraplegia, Tropical,Spastic Paraplegias, Tropical,Tropical Spastic Parapareses,Tropical Spastic Paraplegia,Tropical Spastic Paraplegias
D018450 Disease Progression The worsening and general progression of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. Clinical Course,Clinical Progression,Disease Exacerbation,Exacerbation, Disease,Progression, Clinical,Progression, Disease

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