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HTLV-1 associated myelopathy/tropical spastic paraparesis

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Other Names:
HAM/TSP; Human T-cell leukemia virus type 1 associated myelopathy/tropical spastic paraparesis; Tropical spastic paraparesis (formerly)
Categories:
HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive disease of the nervous system that affects less than 2% of people with HTLV-1 infection. Signs and symptoms vary but may include slowly progressive weakness and spasticity of one or both legs, exaggerated reflexes, muscle contractions in the ankle, and lower back pain. Other features may include urinary incontinence and minor sensory changes, especially burning or prickling sensations and loss of vibration sense.[1] The reason some people with HTLV-1 infection develop HAM/TSTP is not well understood.[1] Treatment generally aims to control the specific symptoms, as there is no standard treatment available.[2] Interferon alpha may be beneficial over short periods, and some aspects of the disease may be improved with interferon beta.[3] Other medications may include immune globulin, oral corticosteroids, and muscle relaxers such as baclofen or tizanidine.[2][4]
Last updated: 7/12/2017
Signs and symptoms of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) vary but may include:[1][3][4]
  • Slowly progressive weakness and spasticity of one or both legs
  • Exaggerated reflexes (hyperreflexia)
  • Stiff muscles
  • Muscle contractions in the ankle (ankle clonus)
  • Lower back pain
  • A 'weak' bladder and/or urinary incontinence
  • Minor sensory changes, especially burning or prickling sensations and loss of vibration sense
Last updated: 7/12/2017
Treatment generally aims to control the specific symptoms, as there is no standard treatment available.[2] Interferon alpha may be beneficial over short periods, and some aspects of the disease may be improved with interferon beta.[3] Stiff and spastic muscles may be treated with lioresal or tizanidine, and urinary dysfunction may be treated with oxybutynin.[3] Corticosteroids were reported to slow progression in one case series and reduce neurologic disability in another. However, others have reported no such benefit with corticosteroids and there have been no randomized clinical trials.[1]
Last updated: 7/12/2017

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to HTLV-1 associated myelopathy/tropical spastic paraparesis. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.
  • The National Multiple Sclerosis Society is a global network of adult and pediatric neurologists, basic scientists, clinicians, representatives of MS societies and other relevant professional organizations, whose vision is to improve worldwide healthcare, education and research in pediatric multiple sclerosis. Click on the link to learn more.
  • The Research Portfolio Online Reporting Tool (RePORT) provides access to reports, data, and analyses of research activities at the National Institutes of Health (NIH), including information on NIH expenditures and the results of NIH-supported research. Although these projects may not conduct studies on humans, you may want to contact the investigators to learn more. To search for studies, enter the disease name in the "Text Search" box. Then click "Submit Query".

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Merck Manual for health care professionals provides information on HTLV-1 associated myelopathy/tropical spastic paraparesis.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss HTLV-1 associated myelopathy/tropical spastic paraparesis. Click on the link to view a sample search on this topic.

Selected Full-Text Journal Articles

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  • Is there treatment or a cure for HAM/TSP or for HTLV-1 in general? See answer


  1. Scadden DT, Freedman AR, Robertson P. Human T-lymphotropic virus type I: Disease associations, diagnosis, and treatment. UpToDate. Waltham, MA: UpToDate; February 16, 2016; http://www.uptodate.com/contents/human-t-lymphotropic-virus-type-i-disease-associations-diagnosis-and-treatment.
  2. Sandbrink F. Tropical Myeloneuropathies Treatment & Management. Medscape Reference. January, 2015; http://emedicine.medscape.com/article/1166055-treatment.
  3. Tropical Spastic Paraparesis Information Page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Tropical-Spastic-Paraparesis-Information-Page. Accessed 7/12/2017.
  4. Rubin M. Tropical Spastic Paraparesis/HTLV-1–Associated Myelopathy (TSP/HAM). Merck Manual. October, 2016; http://www.merckmanuals.com/professional/neurologic-disorders/spinal-cord-disorders/tropical-spastic-paraparesis-htlv-1%E2%80%93associated-myelopathy-tsp-ham.