Laboratory findings
Somatosensory evoked potential (tibial nerve stimulation); right 51.0ms, left 48.0ms(32.6-40.8ms)
Magnetic stimulation motion evoked potential; right 44.1ms, left 43.2ms(25.0-30.8ms)
Central motor conduction time (CMCT); right 26.2ms, left 27.8ms(7.6-13.2ms)
MRI (cervical and thoratic spine); no abnormality
Serum anti-HTLV-1 antibody; positive
Cerebrospinal fluid anti-HTLV-1 antibody; positive (512 times)
Cerebrospinal fluid IgG index; increased
Based on the above results and physical exam, she was diagnosed with HAM/TSP.
At the age of 20, one year after the initial diagnosis, aggravation of gait disorder appeared, steroid pulse therapy was performed with a diagnosis of acute exacerbation. Her gait was stable and she was discharged and outpatient managed.
Her symptoms of spastic paraplegia gradually worsened, and two years after her initial diagnosis, she became unable to walk on her own and began to use a wheelchair in daily life. At the same time, she had dysuria and began to do self-intermittent catheterization for bladder dysfunction. And she had had a urinary tract infection (UTI) twice before her first pregnancy.