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March 1989

Chronic Myelopathies Associated With Human T-Lymphotropic Virus Type I: A Clinical, Serologic, and Immunovirologic Study of Ten Patients in France

Author Affiliations

From the Neurology and Neuropsychology Clinic (Drs Gout, Tournier-Lasserve, Lhermitte, and Lyon-Caen), and the Clinic for Nervous System Diseases (Drs Bolgert and Brunet), Salpétrière Hospital, and the Laboratory of Leukemia Virology, Saint-Louis Hospital (Drs Gessain, Saal, and Lasneret), Paris; the Laboratory of Epidemiology and Immunovirology of Tumors, Faculty of Medicine Alexis Carrel (Drs Gessain and De-Thé), and the Laboratory of Immunobiology, Neurological Hospital (Dr Caudie), Lyon, France. Dr Gessain is a fellow of the Association for Cancer Research.

Arch Neurol. 1989;46(3):255-260. doi:10.1001/archneur.1989.00520390021009

• Chronic myelopathy associated with human T-lymphotropic virus type I (HTLVI) has been described in HTLV-I endemic areas. In Paris, 167 neurologic patients were screened for HTLV-I by enzymelinked immunosorbent, indirect immunofluorescent, and Western blot assays. Ten of the 11 patients with positive results had a chronic spastic paraparesis with IgG oligoclonal bands and elevated HTLV-I antibody index. Two of them had been born and were living in France, without HTLV-I risk factors. Evoked potentials were abnormal in the nine tested patients and brain magnetic resonance images in three of seven patients. No improvement was observed with steroid treatment. A retrovirus similar to HTLV-I was isolated in five cases at different periods of the disease. Hypotheses of limited endemic areas in western countries are discussed. Early presence and persistence of HTLV-I suggest that it is the etiologic agent.