HTLV-1-associated myelopathy (aka tropical spastic paraparesis) is
This condition has been independently described in Japan (HTLV-1 associated myelopathy) and in the Caribbean (tropical spastic paraparesis), and it is now often referred to by both terms, i.e. HTLV-1-associated myelopathy/tropical spastic paraparesis) 1.
HTLV-1 is only present in some parts of the world, endemic in Japan, and also found in the Caribbean, some parts of Africa and Melanesia 1. It is transmitted by blood (transfusion, IVDU) and other bodily fluids (breast feeding, sexual intercourse) 1.
In addition of myelopathy, HTLV-1 can result in adult T-cell leukemia, uveitis and arthropathy 1.
MRI is the modality of choice to evaluate both cranial and spinal cord manifestations.
Although the cord manifestations are the best known features of over half of affected individuals will also demonstrate high T2 signal in the cerebral white matter 2.