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Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis. A diagnostic challenge. Case report.


Arq Neuropsiquiatr. 1999 Jun;57(2A):284-7. Unique Identifier : AIDSLINE

Human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common chronic myelopathy in Brazil. We present the case of a 53 year old man that fulfilled the diagnostic criteria for HAM/TSP but had at the magnetic resonance imaging (MRI) of the spinal cord evidences of syringohydromyelia at the C6-C7 and D2-D7 levels along with Chiari type I malformation. The clinical picture was more typical of HAM/TSP than of syringohydromyelia, which was probably asymptomatic. The present case clearly demonstrates that serology and neuroimaging should be always used together. We conclude that, specially in places where HTLV-I is endemic, every patient with a spastic paraparesis, even with a radiological picture suggestive of a structural spinal cord lesion, should have a screening test for HTLV-I. The clinical picture must dictate the final direction of the diagnosis.

JOURNAL ARTICLE Case Report Human Magnetic Resonance Imaging Male Middle Age Paraparesis, Tropical Spastic/COMPLICATIONS/*DIAGNOSIS Spinal Cord/PATHOLOGY Support, Non-U.S. Gov't Syringomyelia/COMPLICATIONS/*DIAGNOSIS


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