Article Text
Abstract
A 53-year-old woman developed subacute onset of upper limb weakness, sensory loss and cerebellar dysfunction. She was known to have human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy. MR scan of the brain showed extensive T2 hyperintensity within the deep and subcortical white matter, with punctate contrast enhancement. Cerebrospinal fluid (CSF) was lymphocytic with very high levels of HTLV-1 provirus in both CSF and peripheral blood lymphocytes. We diagnosed HTLV-1 encephalomyelitis and started high-dose methylprednisolone followed by a slow corticosteroid taper. She recovered well and regained functional independence in the upper limbs. Neurological manifestations of HTLV-1 infection extend beyond classical ‘tropical spastic paraparesis’ and are under-recognised. We review the literature on HTLV-1 encephalitis and discuss its diagnosis and management.
- HTLV1
- myelopathy
- infectious diseases
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Statistics from Altmetric.com
Read the full text or download the PDF:
Other content recommended for you
- HTLV-1 infections
- Neurological morbidity among human T-lymphotropic-virus-type-1-infected individuals in a rural West African population
- Rapid onset and progression of myelopathy following an STI: a case for screening?
- HTLV-1 and HIV infections of the central nervous system in tropical areas
- The neurology of HTLV-1 infection
- High prevalence of Sjögren’s syndrome in patients with HTLV-I associated myelopathy
- Human T cell leukaemia virus type I associated neuromuscular disease causing respiratory failure
- Myelopathy but normal MRI: where next?
- Cerebellitis in a human T-lymphotropic virus type 1 carrier: a case report
- A 15-year prospective longitudinal study of disease progression in patients with HTLV-1 associated myelopathy in the UK