Case Report: Cognitive Impairment without Clinical Spinal Disease May Be the First Sign of HTLV-1 Neurological Alteration

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dc.creatorAline Rejane Rosa de Castro
dc.creatorLuciana Macedo de Resende
dc.creatorLudimila Labanca
dc.creatorDenise Utsch Gonçalves
dc.date.accessioned2023-08-09T21:47:24Z
dc.date.accessioned2025-09-09T01:34:02Z
dc.date.available2023-08-09T21:47:24Z
dc.date.issued2020
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.4269/ajtmh.19-0218
dc.identifier.issn0002-9637
dc.identifier.urihttps://hdl.handle.net/1843/57671
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofAmerican Journal of Tropical Medicine and Hygiene
dc.rightsAcesso Restrito
dc.subjectDisfunção Cognitiva
dc.subjectDoenças da Coluna Vertebral
dc.subjectVírus Linfotrópico T Tipo 1 Humano
dc.subject.otherCognitive Impairment
dc.subject.otherSpinal Disease
dc.subject.otherHuman t-cell lymphotropic virus
dc.titleCase Report: Cognitive Impairment without Clinical Spinal Disease May Be the First Sign of HTLV-1 Neurological Alteration
dc.typeArtigo de periódico
local.citation.epage369
local.citation.spage366
local.citation.volume102
local.description.resumoAbstract. Human t-cell lymphotropic virus type 1 (HTLV-1)–associated myelopathy (HAM) is a progressive neurological disease whose diagnosis is defined by clinical manifestations and seropositivity for HTLV-1 infection. Cognitiveimpairment (CI) is considered to occur after spinal impairment. A 51-year-old HTLV-1–infected man classified as an asymptomatic carrier presented difficulties in listening comprehension and executive memory. He was assessed for central auditory processing (CAP), cognition (event-related auditory evoked potential [P300]), and otoneurological functions (galvanic vestibular-evoked myogenic potential [gVEMP]). Altered responses were found in CAP, P300, and gVEMP, but the neurological examination and cognitive screening were normal. After a 2-year follow-up, we disclosed a positive Babinski sign, a mild CI, worsened P300, and gVEMP latencies, and the patient reported progressive lumbar pain and difficulty running. He was, then, reclassified as HAM. The first examination, in 2016, had already shown abnormal results in P300 and gVEMP despite the HTLV-1–asymptomatic carrier status. Therefore, tests that provide subclinical measures of neurological disease progression can be useful tools for an early diagnosis and intervention in HTLV-1 patients. Electrophysiological results had worsened as well as the clinical status and the cognitive function and the progression from asymptomatic status to an HTLV-1 associated neurological disease occurred within 2 years. Thus, HTLV-1–infected individuals with complaints of CI, hearing, or otoneurological manifestations should be submitted to neuropsychological and electrophysiological tests, allowing them to be properly cared in case of HAM progression.
local.identifier.orcidhttps://orcid.org/0000-0003-3296-4800
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE FONOAUDIOLOGIA
local.publisher.departmentMED - DEPARTAMENTO DE OFTALMOLOGIA E OTORRINOLARINGOLOGIA
local.publisher.initialsUFMG
local.url.externahttps://www.ajtmh.org/view/journals/tpmd/102/2/article-p366.xml

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