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A crippling virus: Diagnosing tropical spastic paraparesis


Beth Rowlands, DNP, GNP-BC, College of Nursing and Health Sciences, University of Massachusetts, 100 Morrissey Blvd., Boston, MA 02125-3394. Tel: 617-287-7500; Fax: 617-287-7527; E-mail:


Purpose: To provide nurse practitioners (NPs) with an overview of the pathogenesis, mode of transmission, clinical presentation, diagnosis, management, and treatment of tropical spastic paraparesis (TSP) caused by the human T-lymphotropic virus type I (HTLV-I).

Data sources: A review of the scientific literature on tropical spastic paraparesis and HTLV I-associated myelopathy was conducted using PubMed and Medline. A case study was used to illustrate the complexity of the disease.

Conclusions: NPs should be aware of the clinical features of TSP to improve diagnostic accuracy of symptomatic patients, reduce transmission rates, and provide appropriate patient counseling. The ability to accurately diagnose TSP early in the disease process and differentiate it from other neurological diseases will lead to improved patient outcomes. Timely diagnosis is important to maximize patient response to pharmacological interventions that are used to treat the clinical manifestations of TSP.

Implications for practice: In this globalized society, NPs will need to be prepared to care for patients who have immigrated to the United States from parts of the world where the HTLV-I virus is endemic.

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