Spastic paraparesis
Overview
Tropical spastic paraparesis (TSP) is an infection of the spinal cord by Human T-lymphotropic virus resulting in paraparesis, weakness of the legs. As the name suggests, it is most common in tropical regions, including the Caribbean and Africa
Symptoms
Progressive muscle weakness; Sensory disturbance Sphincter dysfunction Urinary incontinence Uveitis arthritis Pulmonary lymphocyte alveolitis Polymyositis Keratoconjunctivitis sicca Infectious dermatitis
Prognosis
HAM/TSP is usually a progressive neurological disorder but it is rarely fatal. Most patients live for several decades after the diagnosis. Their prognosis improves if they take steps to prevent urinary tract infection and skin sore formation, and if they enroll in physical and occupational therapy programs.
Treatment
There is no established treatment program for HAM/TSP although some patients may be given steroids. Clinical studies using interferon alpha and plasmapheresis have not shown significant patient improvement. Spasticity may be treated with lioresal or tizanidine. Urinary dysfunction should be treated with self-catheterization or oxybutynin.