Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)

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)...

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Main Authors: ABELARDO DE QUEIROZ-CAMPOS ARAÚJO, ANA CLAÚDIA CELESTINO BEZERRA LEITE, ANDRÉ LUIZ DOS ANJOS DE OLIVEIRA, CRISTIANE RIBEIRO DE ALMEIDA AFONSO, JULIANA PIES
Format: Article
Language:English
Published: Thieme Revinter Publicações 1999-06-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000200019&tlng=en
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author ABELARDO DE QUEIROZ-CAMPOS ARAÚJO
ANA CLAÚDIA CELESTINO BEZERRA LEITE
ANDRÉ LUIZ DOS ANJOS DE OLIVEIRA
CRISTIANE RIBEIRO DE ALMEIDA AFONSO
JULIANA PIES
author_facet ABELARDO DE QUEIROZ-CAMPOS ARAÚJO
ANA CLAÚDIA CELESTINO BEZERRA LEITE
ANDRÉ LUIZ DOS ANJOS DE OLIVEIRA
CRISTIANE RIBEIRO DE ALMEIDA AFONSO
JULIANA PIES
author_sort ABELARDO DE QUEIROZ-CAMPOS ARAÚJO
collection DOAJ
description 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 1 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.
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spelling doaj-art-0eb8bf45b0034f44a3387be033023b302025-08-20T02:02:09ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42271999-06-01572A28428710.1590/S0004-282X1999000200019Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)ABELARDO DE QUEIROZ-CAMPOS ARAÚJO0ANA CLAÚDIA CELESTINO BEZERRA LEITE1ANDRÉ LUIZ DOS ANJOS DE OLIVEIRACRISTIANE RIBEIRO DE ALMEIDA AFONSO2JULIANA PIES3Fundação Oswaldo CruzFundação Oswaldo CruzFundação Oswaldo CruzFundação Oswaldo CruzHuman 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 1 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000200019&tlng=enHTLV-Itropical spastic paraparesissyringomyeliahydromyeliamagnetic resonance imagingdifferential diagnosis
spellingShingle ABELARDO DE QUEIROZ-CAMPOS ARAÚJO
ANA CLAÚDIA CELESTINO BEZERRA LEITE
ANDRÉ LUIZ DOS ANJOS DE OLIVEIRA
CRISTIANE RIBEIRO DE ALMEIDA AFONSO
JULIANA PIES
Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
Arquivos de Neuro-Psiquiatria
HTLV-I
tropical spastic paraparesis
syringomyelia
hydromyelia
magnetic resonance imaging
differential diagnosis
title Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
title_full Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
title_fullStr Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
title_full_unstemmed Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
title_short Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report)
title_sort syringohydromyelia or htlv i associated myelopathy tropical spastic paraparesis a diagnostic challenge case report
topic HTLV-I
tropical spastic paraparesis
syringomyelia
hydromyelia
magnetic resonance imaging
differential diagnosis
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000200019&tlng=en
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