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NEUROLOGY 1987;37:1323
© 1987 American Academy of Neurology

Tropical spastic paraparesis in the Seychelles Islands

A clinical and case-control neuroepidemiologic study

G. C. Román, MD, FACP, P. S. Spencer, PhD, MRCPath, B. S. Schoenberg, MD, DrPH, J. Hugon, MD, A. Ludolph, MD, P. Rodgers-Johnson, MD, B. O. Osuntokun, PhD, MD, DSc and C. F. Shamlaye, MBChB, MSc (Epidemiology)

Department of Neurology (Dr. Román), Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX; the Institute of Neurotoxicology and the Departments of Neuroscience, Neurology and Pathology (Dr. Spencer), Albert Einstein College of Medicine, Bronx, NY; the Neuroepidemiology Branch (Dr. Schoenberg) and the Laboratory of Central Nervous System Studies (Dr. Rodgers-Johnson), National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, MD the Service de Neurologie and the Institut d'Epidémiologie Neurologique et de Neurologie Tropicale (Dr. Hugon), Centre Hospitalier Régional et Universitaire, Limoges, France; the Psychiatrische und Nervenklinik der Westfälischen Wilhelms-Universität (Dr. Ludolph), Abt.: Klinik für Neurologie, Münster, West Germany; the Department of Medicine (Dr. Osuntokun), University College Hospital, Ibadan, Nigeria; and the Ministry of Health (Dr. Shamlaye), Republic of Seychelles, Victoria, Seychelles.

We confirmed the occurrence of endemic tropical spastic paraparesis (TSP) in the Seychelles. Most patients (14/21) were low-income black women. Mean age at onset was 42.8 years (range, 20 to 65). In 62%, onset and progression were slow. Complete paralysis developed in 8/21 (38%) after an evolution of 2 to 15 years. All patients had bilateral pyramidal signs. Loss of vibratory perception occurred in 6/21 (28%). A case-control study of putative risk factors failed to show significant differences. The clinical and epidemiologic features of TSP in the Seychelles appear to be similar to those described in other tropical countries.

Address correspondence and reprint requests to Dr. G. C. Román, Department of Neurology, Room 4A124, Texas Tech University HSCSM, Lubbock, TX 79430.

Supported in part by a US Foreign Assistance Grant to the Government of the Seychelles, administered by the Third World Medical Research Foundation, Inc. Fieldwork of Drs. Román, Hugon, and Ludolph was supported by this source.

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received November 5, 1986. Accepted for publication in final form January 14, 1987.






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