PERIPHERAL NERVOUS-SYSTEM AND SKELETAL-MU SCLE INVOLVEMENT IN HTLV1-RELATED PARAPLEGIA

The main neurological manifestation due to Human T-Cell Lymphotropic V irus type 1 (HTLVI) infection is a chronic spastic paraparesis called HTLV1-associated paraparesis (HAP). Since 1985, we observed in Martini que (French West Indies) 276 cases of HAP. Among them, 70 patients ful filled clinical, electrophysiological or histological criteria of asso ciated peipheral nervous system involvement (42/70), myositis (8/70), or both (20/70). Muscle biopsy revealed neurogenic atrophy of muscle f ibers or myositic changes in 41/70. Neuromuscular involvement was only mild in 19/70. On the other hand, 25 patients presented with a syndro me mimicking amyotrophic lateral sclerosis, and 7 other patients with features of polymyositis. This study shows that neurological manifesta tions associated to HTLV1 infection may be more complex than the well- known chronic spastic paraparesis, since 25.4% of the HAP Martinican p atients exhibit neuropathic or myositic features.