neurologic disorders
HTLV 1–Associated Myelopathy Tropical Spastic Paraparesis (HAM TSP)
Key Points
HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) affects < 2% of HTLV-1 carriers and occurs more commonly in women. Symptoms include gradually developing spastic weakness in both legs, extensor plantar responses, bilateral symmetric loss of position and vibratory sensation in the feet, and absent Achilles tendon reflexes. Diagnose using serum and CSF serologic tests, PCR tests, and MRI. Interferon alfa, IV immune globulin, and corticosteroids (eg, oralmethylprednisolone) may have some benefit; treat spasticity withbaclofenortizanidine. 