Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1991 Aug;54(8):689–694. doi: 10.1136/jnnp.54.8.689

Multiple sclerosis, tropical spastic paraparesis and HTLV-1 infection in Afro-Caribbean patients in the United Kingdom.

P Rudge 1, A Ali 1, J K Cruickshank 1
PMCID: PMC1014471  PMID: 1940939

Abstract

Forty four consecutive patients of Afro-Caribbean origin resident in the United Kingdom (UK) were studied, based on a provisional diagnosis of myelopathy of unknown cause, tropical spastic paraparesis (TSP) or multiple sclerosis (MS). Of 30 patients with progressive paraparesis 27 had serum antibodies to HTLV-1 and were classified as having TSP. Fourteen patients fulfilled the criteria for MS and none of 12 tested had HTLV-1 antibodies. All the TSP patients and nine of those with MS were born in the West Indies. Five of the West Indianborn MS patients had migrated to the UK after adolescence but the duration of residence in the UK before symptoms of MS developed was similar to those born in the UK (average 18 years). The features that differentiated MS from TSP patients, apart from HTLV-1 status, included clinical evidence of cranial nerve involvement, more extensive abnormalities on the brain and cervical cord MRI and asymmetry of the VEP latency increase, all of which were more frequent in the MS group. Of the three patients without a diagnosis one, born in the UK, had marked abnormalities on MRI of the brain indistinguishable from those seen in MS.

Full text

PDF
689

Images in this article

691Image
on p.691
691Image
on p.691
692Image
on p.692

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bhigjee A. I., Kelbe C., Haribhai H. C., Windsor I. M., Hoffmann M. H., Modi G., Bill P. L., Becker W. B., Singh B., Engelbrecht S. Myelopathy associated with human T cell lymphotropic virus type I (HTLV-I) in natal, South Africa. A clinical and investigative study in 24 patients. Brain. 1990 Oct;113(Pt 5):1307–1320. doi: 10.1093/brain/113.5.1307. [DOI] [PubMed] [Google Scholar]
  2. Confavreux C., Aimard G., Devic M. Course and prognosis of multiple sclerosis assessed by the computerized data processing of 349 patients. Brain. 1980 Jun;103(2):281–300. doi: 10.1093/brain/103.2.281. [DOI] [PubMed] [Google Scholar]
  3. Cruickshank J. K., Richardson J. H., Morgan O. S., Porter J., Klenerman P., Knight J., Newell A. L., Rudge P., Dalgleish A. G. Screening for prolonged incubation of HTLV-I infection in British and Jamaican relatives of British patients with tropical spastic paraparesis. BMJ. 1990 Feb 3;300(6720):300–304. doi: 10.1136/bmj.300.6720.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cruickshank J. K., Rudge P., Dalgleish A. G., Newton M., McLean B. N., Barnard R. O., Kendall B. E., Miller D. H. Tropical spastic paraparesis and human T cell lymphotropic virus type 1 in the United Kingdom. Brain. 1989 Aug;112(Pt 4):1057–1090. doi: 10.1093/brain/112.4.1057. [DOI] [PubMed] [Google Scholar]
  5. Dalgleish A., Richardson J., Matutes E., Cruickshank K., Newell A., Sinclair A., Thorpe R., Brasher M., Weber J., Catovsky D. HTLV-1 infection in tropical spastic paraparesis: lymphocyte culture and serologic response. AIDS Res Hum Retroviruses. 1988 Dec;4(6):475–485. doi: 10.1089/aid.1988.4.475. [DOI] [PubMed] [Google Scholar]
  6. Dean G. Annual incidence, prevalence, and mortality of multiple sclerosis in white South-African-born and in white immigrants to South Africa. Br Med J. 1967 Jun 17;2(5554):724–730. doi: 10.1136/bmj.2.5554.724. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dean G., McLoughlin H., Brady R., Adelstein A. M., Tallett-Williams J. Multiple sclerosis among immigrants in Greater London. Br Med J. 1976 Apr 10;1(6014):861–864. doi: 10.1136/bmj.1.6014.861. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Elian M., Dean G. Multiple sclerosis among the United Kingdom-born children of immigrants from the West Indies. J Neurol Neurosurg Psychiatry. 1987 Mar;50(3):327–332. doi: 10.1136/jnnp.50.3.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Elian M., Nightingale S., Dean G. Multiple sclerosis among United Kingdom-born children of immigrants from the Indian subcontinent, Africa and the West Indies. J Neurol Neurosurg Psychiatry. 1990 Oct;53(10):906–911. doi: 10.1136/jnnp.53.10.906. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gessain A., Barin F., Vernant J. C., Gout O., Maurs L., Calender A., de Thé G. Antibodies to human T-lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet. 1985 Aug 24;2(8452):407–410. doi: 10.1016/s0140-6736(85)92734-5. [DOI] [PubMed] [Google Scholar]
  11. Gout O., Gessain A., Bolgert F., Saal F., Tournier-Lasserve E., Lasneret J., Caudie C., Brunet P., De-Thé G., Lhermitte F. Chronic myelopathies associated with human T-lymphotropic virus type I. A clinical, serologic, and immunovirologic study of ten patients in France. Arch Neurol. 1989 Mar;46(3):255–260. doi: 10.1001/archneur.1989.00520390021009. [DOI] [PubMed] [Google Scholar]
  12. Greenberg S. J., Ehrlich G. D., Abbott M. A., Hurwitz B. J., Waldmann T. A., Poiesz B. J. Detection of sequences homologous to human retroviral DNA in multiple sclerosis by gene amplification. Proc Natl Acad Sci U S A. 1989 Apr;86(8):2878–2882. doi: 10.1073/pnas.86.8.2878. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Iwasaki Y. Pathology of chronic myelopathy associated with HTLV-I infection (HAM/TSP). J Neurol Sci. 1990 Apr;96(1):103–123. doi: 10.1016/0022-510x(90)90060-z. [DOI] [PubMed] [Google Scholar]
  14. Kayembe K., Goubau P., Desmyter J., Vlietinck R., Carton H. A cluster of HTLV-1 associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):4–10. doi: 10.1136/jnnp.53.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Link H., Cruz M., Gessain A., Gout O., de Thé G., Kam-Hansen S. Chronic progressive myelopathy associated with HTLV-I: oligoclonal IgG and anti-HTLV-I IgG antibodies in cerebrospinal fluid and serum. Neurology. 1989 Dec;39(12):1566–1572. doi: 10.1212/wnl.39.12.1566. [DOI] [PubMed] [Google Scholar]
  16. MONTGOMERY R. D., CRUICKSHANK E. K., ROBERTSON W. B., MCMENEMEY W. H. CLINICAL AND PATHOLOGICAL OBSERVATIONS ON JAMAICAN NEUROPATHY; A REPORT ON 206 CASES. Brain. 1964 Sep;87:425–462. doi: 10.1093/brain/87.3.425. [DOI] [PubMed] [Google Scholar]
  17. McLean B. N., Rudge P., Thompson E. J. Viral specific IgG and IgM antibodies in the CSF of patients with tropical spastic paraparesis. J Neurol. 1989 Sep;236(6):351–352. doi: 10.1007/BF00314379. [DOI] [PubMed] [Google Scholar]
  18. Morgan O. S., Montgomery R. D., Rodgers-Johnson P. The myeloneuropathies of Jamaica: an unfolding story. Q J Med. 1988 Apr;67(252):273–281. [PubMed] [Google Scholar]
  19. Newton M., Cruickshank K., Miller D., Dalgleish A., Rudge P., Clayden S., Moseley I. Antibody to human T-lymphotropic virus type 1 in West-Indian-born UK residents with spastic paraparesis. Lancet. 1987 Feb 21;1(8530):415–416. doi: 10.1016/s0140-6736(87)90120-6. [DOI] [PubMed] [Google Scholar]
  20. PCR analysis of DNA from multiple sclerosis patients for the presence of HTLV-I. Science. 1989 Nov 10;246(4931):821–824. [PubMed] [Google Scholar]
  21. PCR analysis of DNA from multiple sclerosis patients for the presence of HTLV-I. Science. 1989 Nov 10;246(4931):821–824. [PubMed] [Google Scholar]
  22. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  23. Reddy E. P., Sandberg-Wollheim M., Mettus R. V., Ray P. E., DeFreitas E., Koprowski H. Amplification and molecular cloning of HTLV-I sequences from DNA of multiple sclerosis patients. Science. 1989 Jan 27;243(4890):529–533. doi: 10.1126/science.2536193. [DOI] [PubMed] [Google Scholar]
  24. Román G. C., Spencer P. S., Schoenberg B. S., Hugon J., Ludolph A., Rodgers-Johnson P., Osuntokun B. O., Shamlaye C. F. Tropical spastic paraparesis in the Seychelles Islands: a clinical and case-control neuroepidemiologic study. Neurology. 1987 Aug;37(8):1323–1328. doi: 10.1212/wnl.37.8.1323. [DOI] [PubMed] [Google Scholar]
  25. Williams E. S., McKeran R. O. Prevalence of multiple sclerosis in a south London borough. Br Med J (Clin Res Ed) 1986 Jul 26;293(6541):237–239. doi: 10.1136/bmj.293.6541.237. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES