title: HTLV-1 and its neurological complications.
abstract: BACKGROUND
  Since its discovery in 1980, human T-cell lymphotropic virus type-1 (HTLV-1) has been associated with a number of neurological diseases. The distribution of HTLV-1-associated neurological disease is worldwide. In endemic areas, up to 30% of the population may be infected with HTLV-1; however, only a small percentage of infected persons develops neurological disease.
  
  
  RESULTS
  In 1986, HTLV-1 infection was reported in patients of chronic progressive myelopathy of uncertain etiology, and the disease entity was called HTLV-1-associated myelopathy/tropical spastic paraparesis. Recently, HTLV-1 infection has been associated with polymyositis and uveitis. Interestingly, a single patient may display more than one syndrome. Although other neurological syndromes occur in HTLV-1-infected individuals, there is not enough epidemiologic data that show a strong association. Treatment of HTLV-1-associated neurological disease is challenging, and well-controlled studies are lacking.
  
  
  CONCLUSIONS
  As neurologists and other scientists begin to understand the pathophysiology of HTLV-1 infection, improved therapies should be developed. Randomized trials with longer follow-up are required to understand the effect of treatment on disability and quality of life.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Khan
authors.forename: T E
authors.initials: TE
authors.lastname: Bertorini
authors.forename: M C
authors.initials: MC
authors.lastname: Levin