Paraparesia espástica progresiva idiopática HTLV-I seronegativa: Estudio clínico y neurofisiológico de las manifestaciones sensitivas
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[1] Universidad de Chile
Universidad de Chile
Santiago, Chile
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- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 129, Nº. 7, 2001, págs. 735-741
- Idioma: español
- Títulos paralelos:
- HTLV-I seronegative idiopathic progressive spastic paraparesis: Clinical and neurophysiological study of the sensory features
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Resumen
Background: HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a defined entity. However, there are many patients not well characterized with a similar clinical picture who are HTLV-I seronegative. Objective: Clinical and neurophysiological description of patients with HTLV-I seronegative idiopathic paraparesia. Patients and Methods: Seventeen patients (4 women and 13 men aged 24-67 years, average 52.3) were evaluated including clinical assessment, vibratory sensory analysis, quantitative somatosensory thermotest (QST), somatosensory evoked potentials (SSEPs), electromyography (EMG) and motor and sensory nerve conductions. Results: In addition to the spastic paraparesis, 3 (17.6%) patients had pseudobulbar symptoms. Ten (58.8%) patients had a spastic gait but could walk unaided, 6 (35.2%) needed support and 1 patient could not walk. Bladder dysfunction was found in 10 (58.8) patients and sensory symptoms in 7 (41.1%). There was mild distal impairment of vibration and position sense, distal tactile and pinprick hypoesthesia in 4 (23.4%) patients. Tibial SSEPs were abnormal in 11 (64.7%). Nerve conduction studies and EMG were normal. QST showed cold hypoesthesia in 14 (82.4%) patients. Warm sensation and heat pain appeared unimpaired. Conclusions: All sensory abnormalities found were restricted to sensations carried by myelinated (A beta and A delta) channels. Sensory and motor abnormalities are similar to HAM/TSP patients suggesting a common pathogenesis (Rev Méd Chile 2001; 129: 731-41)
