HTLV-1 associated myelopathy is also known as or subsumes Tropical spastic paraparesis. -ed.
The author’s update of this article on HTLV-1 associated myelopathy is an essential tool for physicians and virologists alike. HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) is essentially a disease of persons of Caribbean and Japanese origins, which has spread among a number of other ethnic groups. Through horizontal transmission, HTLV-1 infection has become more frequent among Caucasians and, thus, HAM/TSP. The author expands on the criteria for diagnosis and stresses their practical value. He brings to the world’s attention the fact that HTLV-1 pandemy is affecting Canadian Natives of the Northwest Pacific and that the disease is starting to appear among Caucasians. The author defines the similarities and differences between primary progressive multiple sclerosis and HTLV-1 associated myelopathy. He describes the main features of the disease, highlighting the progress made in the biology, epidemiology, and clinical as well as MRI phenotyping. Unfortunately, treatment of the disease has remained disappointing. His clinical experience of the disease, bench work, and insights from many scientific publications will benefit clinicians faced with diagnosing and treating this virally induced inflammatory myelopathy.