HTLV1 معرفي دو مورد نادر از عوارض عصبي ناشي از

Neurological Complications of HTLV-1 (Report of Two Rare Cases)

HAM is an endemic neurologic disorder in many tropical and subtropical countries including North of Khorasan Province-Northeastern of Iran. The typical clinical presentation of this disease is a progressive myelopathic syndrome with spastic paraparesis, pain, paresthesia and difficulty in sphincteric control (4,9,10,11). In addition to myelopathy, HTLV-I produces a lot of neurological syndromes such as cerebellar, bulbar, ALS-like, neuropathic and even myopathic syndrome (1,3,10,11). Itʹs attractive that HTLV-I could imitate neuroimaging (MRI) findings of degenerative (such as cerebellar and spinal atrophy) and demyelinating disease (Multiple Sclerosis); so it shares the differential diagnosis with many other neurological diseases (2,3). The diagnosis will be made too difficult because only a small proportion of HTLV-I infected individuals (estimated at 2-5^/o) develop a myelopathy or any other syndromes (10). Therefore, positive serologic tests Elisa for this virus in the blood alone are not a reason of HAM/TSP disease (7). In this article, we have presented two cases of this disease with respect to clinical presentations and neuroimaging (MRI) findings. First patient referred to our center with a predominantly cerebellar ataxia. The serologic tests of HTLV-I in the CSF and blood documented the disease. MRI revealed cerebellar and spinal atrophy, second patient admitted with a typical myelopathic syndrome and CSF and blood serologic and PCR tests confirmed HAM/TSP with her. Brain T2-W MRI of this patient revealed a lot of hypersignal plaques. It is interesting that without any evidence of ouvert visual derangement, there was an increased P-100 latency on VEP. So the relation between demyelinating disease (MS) and neurological features of HTLV-I (clinical and paraclinical, especially MRI findings) is attractive.