Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Fulminant Myelopathy following Neurogenic Proximal Weakness Associated with Human T-Cell Lymphotropic Virus Type I Infection
Satoshi YamashitaAkihiko UedaTomoo HiraharaEn KimuraTeruyuki HiranoMakoto Uchino
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JOURNALS OPEN ACCESS

2011 Volume 50 Issue 8 Pages 919-924

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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.

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© 2011 by The Japanese Society of Internal Medicine
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