Spinocerebellar syndrome in patients infected with human T-lymphotropic virus types I and II (HTLV-I/HTLV-II): Report of 3 cases from Panama

Luis C. Castillo, F. Gracia, G. C. Román, P. Levine, W. C. Reeves, J. Kaplan

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Cerebellar symptoms at onset are unusual in HTLV-I/II-associated tropical spastic paraparesis (TSP). A prospective study of neurological disorders in Panama (1985-1990) revealed 13 patients with TSP and 3 with HTLV-I/II-associated spinocerebellar syndrome (HSCS) presenting at onset loss of balance, wide-based stance and gait, truncal instability, and mild leg ataxia (vermian cerebellar syndrome), with absent upper limb dysmetria but with postural tremor, downbeat nystagmus, and dysarthria. In 4-5 years, spinal cord manifestations of TSP developed, including spastic paraparesis, pyramidal signs, bladder and sphincter disturbances. Two patients were infected with HTLV-I and another one, a Guaymi Amerindian woman, with HTLV- II. Magnetic resonance imaging (MRI) demonstrated cerebellar atrophy involving predominantly the superior vermis. Mild axonal peripheral neuropathy in the lower limbs, dorsal column involvement and inflammatory myopathy were found by neurophysiology studies. There are 14 similar cases reported in Japan and Canada, but to our knowledge these are the first documented cases of HSCS in the tropics. A cerebellar syndrome constitutes another form of presentation of HTLV-I/II infection of the nervous system.

Original languageEnglish (US)
Pages (from-to)405-412
Number of pages8
JournalActa Neurologica Scandinavica
Issue number6
StatePublished - 2000


  • Cerebellar disorders
  • HTLV-I
  • Human retroviruses
  • Magnetic resonance imaging
  • Panama
  • Tropical spastic paraparesis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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