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Gustavo C. Román, MD; Bruce S. Schoenberg, MD, DPH; David L. Madden, DVM, PhD; John L. Sever, MD, PhD; Jacques Hugon, MD; Albert Ludolph, MD; Peter S. Spencer, PhD, MRCPath

Arch Neurol. 1987;44(6):605-607.

Abstract
• Tropical spastic paraparesis (TSP), a chronic myelopathy of unknown etiology, was studied in the Seychelles. Human T-lymphotropic virus type I (HTLV-I) and human immunodeficiency virus antibodies were determined using an enzyme-linked immunosorbent assay and confirmed with an indirect fluorescent antibody test in serum samples of 20 patients with TSP and 16 controls. Test results indicated that 17 patients (85%) and two controls (transverse myelopathy and clinically probable multiple sclerosis) were positive for HTLV-I. Serum samples of nine healthy controls and five with other neurologic diseases were negative for HTLV-I. No serum samples were positive for human immunodeficiency virus. Estimated relative risk for TSP in those subjects whose serum is positive for HTLV-I antibodies is 40. This result is highly statistically significant. Although primarily associated with adult T-cell leukemia and non-Hodgkin's lymphoma, HTLV-I could also be an etiologic agent of TSP.

Author Affiliations
From the Department of Neurology, Texas Tech University Health Sciences Center School of Medicine, Lubbock (Dr Román); the Neuroepidemiology Branch (Dr Schoenberg) and the Immunochemistry and Clinical Investigations Section (Drs Madden and Sever), Infectious Diseases Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Md; the Service de Neurologie and the Institut d'Épidémiologie Neurologique et de Neurologie Tropicale, Limoges, France (Dr Hugon); the Psychiatrische und Nervenklinik der Westfalischen Wilhelms-Universität, Klinik für Neurologie, Münster, West Germany (Dr Ludolph); and the Departments of Neuroscience, Neurology, and Pathology, Albert Einstein College of Medicine, Bronx, NY (Dr Spencer).

Footnotes
Accepted for publication Jan 9, 1987.

Reprint requests to Department of Neurology, Room 4A124, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430 (Dr Román).

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