HTLV1-ASSOCIATED PARAPLEGIA IN MARTINIQUE - A STUDY OF 271 CASES INCLUDING 70 WITH NEUROMUSCULAR INVOLVEMENT

To date, 271 cases of HTLV1-associated paraplegia have been observed i n Martinique (French West Indies). The clinical picture consisted most ly in a spastic paraparesis or paraplegia with sphincter disturbances (80%) and lower limbs pains (60%). The severity of the disease appeare d variable: after a mean disease duration of 6.5 years, 40% of the pat ients could walk without help, 35% used a single crutch, and 25% used a couple of crutches or were confined to a wheelchair. A variable neur omuscular component was observed in 70 cases (25.4%). In 38 cases, the peripheral signs (SIGNS) or the myositis were only mild. In contrast, 25 patients presented with severe amyotrophy evoking amyotrophic late ral sclerosis, and 7 other had features of dermatopolymyositis. Lastly , an extra-neural spreading of the disease was extremely frequent, inc luding lymphocytic alveolitis (76%), sicca syndrome (69%) and more rar ely uveitis, arthritis or vasculitis.