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Tropical spastic paraparesis in Ecuador. Preliminary report

Abstract:

Tropical spastic paraparesis (TSP) is a chronic myeloneuronophaty endemic in coastal or insular regions related to the equator, that has been clasically associated with toxic, nutritional or infectious factors. Recently, the role of human T-lymphotropic virus type I (HTLV-I) in the genesis of this disorder has been widely investigated. In this study, we report the first 10 patients with TSP diagnosed in Ecuador. Seven of these patients were women, and 3 were men. The median age was 61 years. All patients had a chronic disease characterized by spastic paraparesis, associated in some cases with mild sensorial disturbances. One patient had muscular atrophy associated with spastic paraparesis, resembling a picture of amyotrophic lateral sclerosis. Detection of antibodies against HTLV-I by ELISA was positive in all patients with TSP and in 2 of 26 healthy individuals or patients with other type of neurological diseases that were used as controls. Western blot testing were positive in 9 out of 10 patients with TSP, and were negative in the 2 ELISA positive controls. Most of our patients with TSP came from tropical islands or port towns in the province of Esmeraldas, near the Republic of Colombia. This preliminary communication confirms the existence of TSP in Ecuador and stresses its possible relation with chronic HTLV-I infection. Further studies are needes to estimate the incidence and prevalence of the disease, and to evaluate its role as a public health problem in our country.