Electrophysiological Analysis Shows Dizziness as the First Symptom in Human T Cell Lymphotropic Virus Type-Associated Myelopathy/Tropical Spastic Paraparesis

LabancaLudimila,; Borges, StarlingAna Lúcia; Roberto, de Sousa-PereiraSilvio; Ferreira, RomanelliLuiz Cláudio; Bárbara, de Freitas Carneiro-ProiettiAnna; Novaes, CarvalhoLucas; Rosa, FernandesDaniele; Gonçalves, Denise Utsch

doi:10.1089/aid.2014.0153

Cited by 14 publications

(19 citation statements)

References 25 publications

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“…The studies about VEMP with auditory stimulation have evidenced this test as an assisting tool for the diagnosis of several types of peripheral vestibular disorders, predominantly Meniere's disease (5,6,29,40) and superior semicircular canal dehiscence (SSCD) (8)(9)(10)(11)32) , as well as diseases related to central vestibular disorders, such as motor myelopathies (19)(20)(21)(22)(23)(24)(25) and Parkinson's disease (15,(41)(42)(43) .…”

Section: Discussionmentioning

confidence: 99%

“…The VEMP has been utilized to study a variety of vestibular diseases. Among peripheral diseases, Meniere's disease (5,6) , vestibular neuritis (7) , superior semicircular canal dehiscence (8)(9)(10) , large vestibular aqueduct syndrome (11) , and vestibular schwannoma (12,13) are highlighted, whereas among central vestibular diseases, vestibular migraine (14) , Parkinson's disease (15) , central ischemic lesions (16)(17)(18) , and motor myelopathies (19)(20)(21)(22)(23)(24)(25) stand out.…”

Section: Introductionmentioning

confidence: 99%

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Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

Silva

Santos

Resende

et al. 2019

Audiol., Commun. Res.

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RESUMO Objetivos Revisar a literatura científica sobre as principais técnicas usadas para gerar o potencial evocado miogênico vestibular (VEMP) e suas aplicações clínicas. Estratégia de pesquisa Os artigos que descrevem os métodos de registro e as aplicações do VEMP foram localizados nas bases de dados PubMed, Web of Science, MEDLINE, Scopus, LILACS e SciELO. O levantamento realizado limitou-se aos artigos publicados nos idiomas Inglês, Português e Espanhol, entre janeiro de 2012 e maio de 2018. Critérios de seleção Artigos sobre os aspectos técnicos para a realização do VEMP ocular, cervical ou do músculo sóleo, com estimulação auditiva ou galvânica e artigos sobre as aplicações clínicas do VEMP foram incluídos; artigos repetidos nas bases de dados, artigos de revisão de literatura, relato de casos, cartas e editoriais foram excluídos. Resultados A estratégia de busca resultou na seleção de 28 artigos. Os estudos evidenciaram três métodos de registro do VEMP: cervical, ocular e no músculo sóleo. As aplicações clínicas do VEMP incluíram doença de Ménière, neurite vestibular, síndrome da deiscência do canal semicircular superior, doença de Parkinson, lesões centrais isquêmicas e mielopatias motoras. Conclusão Independentemente da técnica de registro, o VEMP mostrou-se útil como ferramenta complementar para o diagnóstico de doenças vestibulares periféricas e centrais.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

Silva

Santos

Resende

et al. 2019

Audiol., Commun. Res.

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“…HAM/TSP is a disease that affects the spinal cord, with a predilection for the medial thoracic segments, but the entire spinal cord may be affected, including fibres that regulate muscle tone; areas such as the cerebellum, the brainstem and the vestibulospinal tract have also been affected 18 19. Postmortem studies have shown areas of demyelination and axonal loss in the anterior, lateral and posterior columns of the spinal cord with perivascular and parenchymal lymphocytic infiltration, and with the presence of foamy macrophages, proliferation of astrocytes and fibrillar gliosis 20…”

Section: Discussionmentioning

confidence: 99%

HTLV-1-associated myelopathy in a solid organ transplant recipient

2016

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Human T-cell lymphotropic virus type-1 (HTLV-1) is endemic in Japan, the Caribbean and in South American countries such as Ecuador. This virus is the cause of HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), a myelopathy characterised by chronic progressive paraparesis, spasticity and urinary symptoms. We report the case of a 40-year-old man who received a kidney transplant from a living donor and developed HAM/TSP, 24 months after transplant. The diagnosis was confirmed by detection of HTLV-1 in blood and cerebrospinal fluid by the ELISA and Western Blot tests. For myelopathy, the patient was treated with pulse methylprednisolone, but had poor response to treatment. We recommend that all patients receiving transplants and their donors who come from endemic countries be given a mandatory screening for HTLV-1 through an ELISA test, in an effort to inform candidates for renal transplantation of the potential risk of infection and the development of this disease.

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“…The subclinical spinal cord injury related to HAM has been already shown 27 through VEMP of cervical and of lower limbs muscles, exams that are used to test 28 the vestibulospinal reflex [11,12,16,19,20]. The present study proposes the use of 29 VEMP of the oculomotor system (ocular VEMP) to test the subcortical pathways 30 associated with body balance to verify the extension of the HTLV-1-neurological 31 damage.…”

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confidence: 97%

“…The complaint of dizziness has proven to be frequent HAM and can be one 13 of the first symptoms of HTLV-1-neurological impairment [11,12]. Therefore, 14 individuals infected with HTLV-1 may present vague complaints, with no motor, 15 sensitive, or autonomic abnormalities [4-6].…”

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Ocular vestibular evoked myogenic potential (VEMP) reveals subcortical HTLV-1-associated neurological disease

Mar

Resende

et al. 2019

Preprint

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Introduction: Vestibular Myogenic Evoked Potential (VEMP) evaluates vestibuloocular and vestibulospinal reflexes associated with posture. Purpose: To compare cervical and ocular VEMP in individuals with HTLV-1 associated myelopathy (HAM) and with HTLV-1-asymptomatic infection. Materials and Methods: This cross-sectional study included 52 HTLV-1-infected individuals (26 HAM and 26asymptomatic carriers) and 26 negative controls. The groups were similar regarding age and gender. Participants underwent ocular and cervical VEMP that were performed simultaneously. The stimulus used to generate VEMP was a sound, lowfrequency toneburst, intensity of 120 decibels normalized hearing level (dB nHL), bandpass filter from 10 to 1,500 Hz, with 100 stimuli at 500 Hertz (Hz) and 50 milliseconds (ms) recording time. An alteration in the electrophysiological waves 3 P13 and N23 for cervical VEMP and N10 and P15 waves for ocular VEMP was compared between groups. Results: Cervical VEMP was different among the groups for P13 (p=0.001) and N23 (p=0.003). Ocular VEMP was similar for N10 (p=0.375) and different for P15 (p=0.000). In the HTLV-1-asymptomatic group, 1(3.8%) individual presented changes in both ocular and cervical VEMP, while in HAM group, 16(61.5%) presented changes in both tests. Conclusion: Neurological impairment in HAM was not restricted to the spinal cord. The mesencephalic and thalamic connections, tested by ocular VEMP, were also altered. Damage of the oculomotor system, responsible for eye stabilization during head and body movements, may explain why dizziness is such a frequent complaint in HAM. Authors' summaryHuman T-cell lymphotropic virus type 1 (HTLV-1) infection is endemic in Brazil and can cause HTLV-1-associated myelopathy (HAM). This neurological disease progresses slowly and, within ten years after its onset, can confine the patient to a wheelchair. Changes in HAM inflammatory characteristics can subsequently occur in the cortex, subcortical white matter, cerebellum, and brainstem. In the present study, we used the electrophysiological test Vestibular Myogenic Evoked Potential (VEMP) to evaluate the thalamic, brainstem, and spinal neural connections. This test evaluates the peripheral and the central vestibular pathway and has been used to test the postural reflexes involved in the control of one's balance. The VEMP from 4 the oculomotor muscles demonstrated that a subcortical impairment occurs in HAM and can also occur in the asymptomatic phase of HTLV-1 infection. 1 Introduction 2 The Human T-cell lymphotropic virus type 1 (HTLV-1) infection affects 3 approximately 5-10 million people worldwide [1]. The majority of the infected 4 individuals remain asymptomatic throughout their lives [2]. The host genetic and 5 immunological factors seem to be related to the development of HTLV-1-associated 6 diseases [1,2].7The range of neurological manifestations of HTLV-1-associated myelopathy 8 (HAM) includes not only the spine, with the classical motor limitations affecting 9 the lower limbs, but also the autonomi...

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Electrophysiological Analysis Shows Dizziness as the First Symptom in Human T Cell Lymphotropic Virus Type-Associated Myelopathy/Tropical Spastic Paraparesis

Cited by 14 publications

References 25 publications

Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

HTLV-1-associated myelopathy in a solid organ transplant recipient

Ocular vestibular evoked myogenic potential (VEMP) reveals subcortical HTLV-1-associated neurological disease

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