title: Clinical features and management of hereditary spastic paraplegia.
abstract: Hereditary spastic paraplegia (HSP) is a group of genetically-determined disorders characterized by progressive spasticity and weakness of lower limbs. An apparently sporadic case of adult-onset spastic paraplegia is a frequent clinical problem and a significant proportion of cases are likely to be of genetic origin. HSP is clinically divided into pure and complicated forms. The later present with a wide range of additional neurological and systemic features. To date, there are up to 60 genetic subtypes described. All modes of monogenic inheritance have been described: autosomal dominant, autosomal recessive, X-linked and mitochondrial traits. Recent advances point to abnormal axonal transport as a key mechanism leading to the degeneration of the long motor neuron axons in the central nervous system in HSP. In this review we aim to address recent advances in the field, placing emphasis on key diagnostic features that will help practicing neurologists to identify and manage these conditions.
authors.affiliation: Departamento de Neurologia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Faber
authors.affiliation: Departamento de Neurologia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Katiane R
authors.initials: KR
authors.lastname: Servelhere
authors.affiliation: Departamento de Neurologia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Alberto R M
authors.initials: AR
authors.lastname: Martinez
authors.affiliation: Departamento de Neurologia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Anelyssa
authors.initials: A
authors.lastname: D'Abreu
authors.affiliation: Departamento de Genetica Medica, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Iscia
authors.initials: I
authors.lastname: Lopes-Cendes
authors.affiliation: Departamento de Neurologia, Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Marcondes C
authors.initials: MC
authors.lastname: França
mesh_terms: D000328:Adult; D005799:Genes, Dominant / Q000235:genetics; D005808:Genes, Recessive / Q000235:genetics; D040181:Genetic Diseases, X-Linked / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D008279:Magnetic Resonance Imaging; D009154:Mutation; D015419:Spastic Paraplegia, Hereditary / Q000145:classification / Q000175:diagnosis / Q000235:genetics*