{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:53:52Z","timestamp":1791824032350,"version":"4.3.4"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2021,7,22]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>A 53-year-old woman developed subacute onset of upper limb weakness, sensory loss and cerebellar dysfunction. She was known to have human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy. MR scan of the brain showed extensive T2 hyperintensity within the deep and subcortical white matter, with punctate contrast enhancement. Cerebrospinal fluid (CSF) was lymphocytic with very high levels of HTLV-1 provirus in both CSF and peripheral blood lymphocytes. We diagnosed HTLV-1 encephalomyelitis and started high-dose methylprednisolone followed by a slow corticosteroid taper. She recovered well and regained functional independence in the upper limbs. Neurological manifestations of HTLV-1 infection extend beyond classical \u2018tropical spastic paraparesis\u2019 and are under-recognised. We review the literature on HTLV-1 encephalitis and discuss its diagnosis and management.<\/jats:p>","DOI":"10.1136\/practneurol-2021-003053","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T13:20:47Z","timestamp":1630329647000},"page":"60-63","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["HTLV-1 encephalitis"],"prefix":"10.1136","volume":"22","author":[{"given":"Josh","family":"King-Robson","sequence":"first","affiliation":[{"name":"Neurology Department, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hampton","sequence":"additional","affiliation":[{"name":"Neuroradiology Department, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Rosadas","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham P","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biba","family":"Stanton","sequence":"additional","affiliation":[{"name":"Neurology Department, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"key":"2025090410524934000_22.1.60.1","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2018.01651","article-title":"Proposal of classification criteria for HTLV-1-Associated myelopathy\/tropical spastic paraparesis disease activity","volume":"9","author":"Sato","year":"2018","journal-title":"Front Microbiol"},{"key":"2025090410524934000_22.1.60.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2005.03.015"},{"key":"2025090410524934000_22.1.60.3","doi-asserted-by":"crossref","DOI":"10.1186\/1742-4690-11-S1-O14","article-title":"Htlv-1 world distribution and estimation of the number of asymptomatic infected carriers","volume":"11","author":"Gessain","year":"2014","journal-title":"Retrovirology"},{"key":"2025090410524934000_22.1.60.4","unstructured":"European Centre for Disease Prevention and Control . 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