title: Fulminant myelopathy following neurogenic proximal weakness associated with human T-cell lymphotropic virus type I infection.
abstract: We report a patient with human T-cell lymphotropic virus type I (HTLV-I) infection, who presented with proximal extremity neurogenic muscular weakness followed by fulminant myelopathy, but with no upper motor symptoms. The symptoms were inconsistent with the World Health Organization or El Escorial criteria for HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) or amyotrophic lateral sclerosis (ALS). This case indicates that fulminant myelopathy without upper motor neuronal symptoms may occur long after the onset of HTLV-I-associated neurogenic proximal muscular weakness. Additionally, we report that treatment with high-dose steroid pulse therapy partially improves symptoms of lightning pain and sensory disturbance.
authors.affiliation: Department of Neurology, Faculty of Life Sciences, Kumamoto University, Japan. y-stsh@kumamoto-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamashita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ueda
authors.forename: Tomoo
authors.initials: T
authors.lastname: Hirahara
authors.forename: En
authors.initials: E
authors.lastname: Kimura
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hirano
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchino
mesh_terms: D000368:Aged; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000473:pathology / Q000503:physiopathology; D009133:Muscular Atrophy / Q000473:pathology / Q000503:physiopathology; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D011239:Prednisolone / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone