[Clinical and para clinical evaluation of peripheral nerves in patients with HTLV1 associated myelopathy]

The main neurological manifestation of Human T-cell Lymphotropic Virus type 1 [HTLV-1] is spastic Paraparesis, of progressive nature, also known as HTLV-1 Associated Myelopathy [HAM] or Tropical Spastic Paraparesis [TSP]. Despite various CNS complications described in HAM/TSP a relatively little attention has been directed toward disorders of the peripheral nervous system [PNS]. The aim of this study was evaluation of HAM/TSP patients about concomitant neuropathy by clinical and neurophysiologic methods. In this descriptive Study 73 Patients with HTLV1 associated myelopathy in Neurology Clinic of Ghaem Hospital were assesed by clinical and neorophysiologic evaluations in 2002-2004. Questionnaire was completed for each patient, and then Median and Ulnar nerves from the upper extremity and Proneal, Tibial and Sural nerves from the lower extremity were evaluated by electrophysiological studies [NCV]. Data was analyzed using descriptive statistics and frequency distribution tables. 65.8% of patients were clinically suspected to neuropathy. In 54.8% of patients with HAM/TSP, there was concomitant peripheral nerve disease. Mononeuropathy in 15 [20.54%], multiplex mononeuropathy in 5 [6.8%], motor sensory polyneuropathy in 17 [23.3%], motor polyneuropathy in 2 [2.7%] and sensory polyneuropathy in 2[2.7%] of patients were present. According to this study electrophysiological compromise of the peripheral nerve is frequent in patients with HTLV-1 associated myelopathy. Furthermore, electrophysiological compromise could arise even when the patient did not present clinical manifestations denoting this kind of problem. Hence, the study of nerve conduction has to become a routine test for patients with HAM/TSP

Detection of the soluble form of the Fas/Apo-1 receptor in patients with human T-lymphotropic virus type 1-associated myelopathy

Fas/Apo-1 mediates apoptosis via Fas and Fas ligand transduction. recently, a soluble form of Fas [sFas] was described which seems to be functionally implicated in the Fas signaling system, suggesting a relationship between some disorders and sfas function. To determine is sFas is involved in the pathogenesis of HTLV-1-associated myelopathy/tropical spastic paraparesis [HAM/TSP], we measured sfas-levels in sera from normal controls, human T lymphotropic virus type-1 [hTLV-1] healthy carriers and patients with HAM/TSP using a highly sensitive enzymelinked immunosorbent assay [ELISA]. The sFas of normal individuals, HTLV-1 carriers, and patients with HAM/TSP, was 0.14 +/- 0.11, 0.26 +/- 0.25, and 0.39 +/- 0.35 ng/ml, respectively. although the level of sFas in patient's group with HAM/TSP, was significantly higher in comparsion to that of normal controls [p< 0.05], the individual values were highly variable within the groups. These results suggest that sFas may play an important role in the pathogenesis of HAM/TSP and that serum sFas may be related to clinical activity in HAM/TSP patients