Tropical spastic paraparesis: A neuroepidemiological study in Colombia

Abstract

A geographic isolate of tropical spastic paraparesis (TSP) in Tumaco, Colombia, is described. Fifity confirmed cases were identified (29 men, 21 women) with an estimated prevalence rario of 98 cases per 100, 000 population. Patients with identified cases ranged in age from 24 to75 years (mean, 46.5). TSP begins with burning feet, leg stiffness, spastic bladder, and, in men, impotence. Patients exhibited leg weakness, spasticity, hyperreflexia, and scissoring gait. Babinski, Chaddock, and Hoffmann signs could elicited. Ankle reflexes and vibratory sensation of the feet were decresed. Intellectual function, coordination, and cranial nerves remained normal. TSP is slowly progressive disorder but so far there have been no deaths from it. Forth cases in this report began between 1971 and 1980; the earliest documented case began in 1952. Living conditions and occupations of the patients were typical for the region. Yaws had occured in 74% of confirmed cases. No likely etiological neurotoxix or nutritional factors identified. TSP aslo has been described in India, Africa, the Seychelles, and Jamaica.