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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Hereditary Spastic Paraparesis : I was diagnosed with Hereditary Spastic Paraparesis about 10 years ago. I had several test done including an MRI, Cat Scan, and Spinal Tap which ruled out MS, tumors, etc. I was wondering whether or not I should have these test done again. Could something "pop up" during this time period. The reason I ask is because no one in my family suffers from HSP and I thought there might be another reason. I'm planning on having a HTLV-1 test done next month. Thanks for help. = Hello, Juliet, Hereditary spastic paraplegia (HSP) is one of the degenerative diseases of the nervous system. The pattern of inheritance is usually autosomal dominant, meaning 50% siblings regardless of sex will have the disease by chance. However, both autosomal recessive and sex chromosome linked HSP have been reported, implying that the patient may be the only person with the disease in the family. In general, patients have a gradual development of spastic weakness of the legs with increasing difficulty in walking. The list of differential diagnosis is long, including tumor, neck degenerative changes (cervical spondylosis), multiple sclerosis, congenital malformation (Chiari malformation), and chronic myelitides (Lyme, sarcoid, AIDS, and tropical spastic paraparesis). Therefore, it is very reasonable to check HTLV-1 at this point. Unfortunately, the treatment of this condition is mainly symptomatic and supportive. Baclofen has been used successfully in many cases to relieve the spasticity. Given your history and presentation, it would be worthwhile reevaluating the entire condition and explore the management options. Such evaluation is usually well done at a tertiary referral center such as the Cleveland Clinic. Please call toll free (800) 223-2273 ext. 45559 for an appointment if traveling to Cleveland is not a problem. Good luck. This information is provided for general medical educational purpose only. Please consult your physician for the diagnostic and treatment options of your specific condition. /1
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