Tropical Spastic Paraparesis and Anesthesia: Case Report and Topic Review
Abstract
Introduction: Tropical spastic paraparesis is an endemic infection in Colombia caused by the HTLV-1 retrovirus. It is characterized by a slow and progressive myelopathy that initially targets lower limbs. Complications such as eschars due to a prolonged decubitus, urinary retention to sphincter dysfunction, fractures, etc. make these patients potential surgery candidates.
Objective: To report a case and to review the physiopathology, epidemiology, clinical manifestations, treatment and basic anesthetic considerations of this disease.
Methods: Case report and topic review. The research included clinical trials, meta-analysis, practice guides, randomized controlled assays, revisions, case reports, classic articles, comparative studies, consensus conferences, magisterial classes and textbooks regarding published articles on tropicalsSpastic paraparesis/HTLV-1 (TSP/HAM) Associated myelopathy and anesthetic implications. Publications focused on etiology, physiopatology, epidemiology, clinical manifestations, treatment and anesthetic repercussions of TSP/ HAM were included in this article. Research was carried out through PubMed, MdConsult, EBSCOhost, OvidSP, and Scielo, of articles in English and Spanish. The MeSH terms used were: paraparesis, tropical spastic, anesthesia and the DeCS terms were: paraparesia espástica tropical, anestesia. Titles and abstracts of articles identified in the database were studied independently.
Results: We describe the case of a male adult patient who was admitted to surgery for urethral reconnection after presenting a classic complication of tropical spastic paraparesis.
Research on the topic yielded 1829 studies. A total 20 writings met the inclusion criteria. We present implications regarding anesthesia and the disease.
References
2. Robert-Guroff M, Weiss SH, Giron JA, Jennings AM, Ginzburg HM, Margolis IB, et al. Prevalence of antibodies to HTLV-I, -II, and -III in intravenous drug abusers from an AIDS endemic region. JAMA. 1986;255:3133-7.
3. Kanmura Y, Komoto R, Kawasaki K, Yoshimura N. Anesthetic considerations in myelopathy associated with human T-cell lymphotropic virus type I (HTLV-I-associated myelopathy: HAM). Anesth Analg. 1996;83:1120-1.
4. Ijichi S, Osame M. Human T lymphotropic virus type I (HTLVI)- associated myelopathy/tropical spastic paraparesis (HAM/TSP): recent perspectives. Intern Med. 1995;34:713-21.
5. Nakamura T. HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP): the role of HTLV-I-infected Th1 cells in the pathogenesis, and therapeutic strategy. Folia Neuropathol. 2009;47:182-94.
6. Gonçalves DU, Proietti FA, Ribas JG, Araújo MG, Pinheiro SR, Guedes AC, et al. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev. 2010;23:577-89.
7. Carneiro-Proietti AB, Catalan-Soares BC, Castro-Costa CM, Murphy EL, Sabino EC, Hisada M, et al. HTLV in the Americas: challenges and perspectives. Rev Panam Salud Publica. 2006;19:44-53.
8. Nitahara K, Matsuyama M, Sakuragi T, Higa K. Depression of evoked electromyographic (EEMG) responses by propofol in a patient with human T-cell lymphotropic virus type I-associated myelopathy (HAM). Anesth Analg. 2000;91:755-7.
9. Kaplan JE, Osame M, Kubota H, Igata A, Nishitani H, Maeda Y, et al. The risk of development of HTLV-I-associated myelopathy/tropical spastic paraparesis among persons infected with HTLV-I. J Acquir Immune Defic Syndr. 1990;3:1096-101.
10. Kendall EA, González E, Espinoza I, Tipismana M, Verdonck K, Clark D, et al. Early neurologic abnormalities associated with human T-cell lymphotropic virus type 1 infection in a cohort of Peruvian children. J Pediatr. 2009;155:700-6.
11. Kuriyama N, Niwa F, Watanabe Y, Yamada K, Tokuda T, Mizuno T, et al. Evaluation of autonomic malfunction in HTLV-1 associated myelopathy (HAM). Auton Neurosci. 2009;150:131-5.
12. Martins FM, Casseb J, Penalva-de-Oliveira AC, De Paiva MF, Watanuki F, Ortega KL. Oral manifestations of human T-cell lymphotropic virus infection in adult patients from Brazil. Oral Dis. 2010;16:167-71.
13. Sonoda S, Li HC, Tajima K. Ethnoepidemiology of HTLV-1 related diseases: ethnic determinants of HTLV-1 susceptibility and its worldwide dispersal. Cancer Sci. 2011;102:295-301.
14. Osame M, Igata A, Usuku K, Rosales RL, Matsumoto M. Mother-to-child transmission in HTLV-I associated myelopathy. Lancet. 1987;1:106.
15. Sugimoto K, Ohmori A, Iranami H, Hatano Y. Tramadol, vecuronium, and thoracic epidural ropivacaine combined with sevoflurane anesthesia in a patient with human T-lymphotropic virus type 1-associated myelopathy. Anesth Analg. 2006;103:1596.
16. Nakamura T, Nishiura Y, Eguchi K. Therapeutic strategies in HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Cent Nerv Syst Agents Med Chem. 2009;9:137-49.
17. Udelsman R, Gallucci WT, Bacher J, Loriaux DL, Chrousos GP. Hemodynamic effects of corticotropin releasing hormone in the anesthetized cynomolgus monkey. Peptides. 1986;7:465-71.
18. Roizen MF, Fleisher LA. Anesthetic implications of concurrent diseases. En: Miller R, editor. Miller's Anesthesia. 7.a ed. Philadelphia: Elsevier; 2009.
19. Jones RM, Healy TE. Anaesthesia and demyelinating disease. Anaesthesia. 1980;35:879-84.
20. Yuasa H, Higashizawa T, Koga Y. Spinal anesthesia in human T lymphotropic virus type I-associated myelopathy. Anesth Analg. 2001;92:1618.
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