Table 1.

The clinical manifestations of pure and complex HSP and a list of the prevalent clinical manifestations observed in HSP.

Pure HSP

Complex HSP

Progressive lower-extremity spastic weakness Difficulty walking—need for canes, walkers, or wheelchairs Mild diminution of lower-extremity vibration sensation Hypertonic urinary bladder disturbance Possible urinary urgency Lower-extremity paraesthesias Normal strength and dexterity of the upper extremities No involvement of speech, chewing, or swallowing Disabling symptoms without shortened life span

Impairments present in uncomplicated HSP plus other neurologic findings such as: Ataxia Seizures Intellectual disability Dementia Muscle atrophy Extrapyramidal disturbance Peripheral neuropathy