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Tropical spastic paraparesis: an old disease with a new name.

T ropical spastic paraparesis (TSP), a progressive myelopathy predominantly affecting the lower limbs, is currently synonymous with human T-lymphotropic virus type I (HTLVI)–associated myelopathy/tropical spastic paraparesis (HAM/TSP). At the turn of the 20th century, Drs Henry Strachan and Henry Scott provided the first clinical descriptions of persons with syndromes resembling HAM/TSP. As HTLV-I was not detected until 1980, these historical references likely included persons who did not have HAM/TSP. In the mid-1980s, the association of HTLV-I with the neurologic syndrome HAM/TSP was reported concurrently in patients from the Caribbean islands, Colombia, Japan, and the Seychelles. Using the original quotations from the seminal articles, this article traces the initial reports of this syndrome, the discovery of the infectious cause, and the development of the clinical definition of the syndrome.