Tropical Spastic Paraparesis – Causes, Symptoms & Treatment

Tropical Spastic Paraparesis

Tropical spastic paraparesis is a disease that manifests itself in partial spastic paralysis in the lower limbs . The occurrence of tropical spastic paraparesis is mainly limited to tropical regions. The abbreviation of Tropical Spastic Paraparesis is TSP, and the disease is also known as HTLV-associated myelopathy.

What is Tropical Spastic Paraparesis?

Tropical spastic paraparesis hardly ever occurs in Germany. Instead, the distribution area of ​​tropical spastic paraparesis is primarily limited to the tropics. Doctors estimate that around 6,000 people in Western Europe are infected with HTLV-1 and are therefore at risk of suffering from tropical spastic paraparesis.

In fact, however, the disease only manifests itself in a small proportion of infected people, namely around one percent. The trigger of tropical spastic paraparesis is found in the HTLV-1 virus, short for human T-lymphotropic virus 1. In terms of its symptoms, the disease is similar to amyotrophic lateral sclerosis and multiple sclerosis . In these diseases, however, there is no infection with HTLV-1 in the sick people.

Tropical spastic paraparesis is most common in Central and South America, southern Japan and Africa. It is believed that tropical spastic paraparesis originated in Africa and spread during colonization. Basically, HTLV-1-associated diseases are relatively new research objects.


Tropical spastic paraparesis occurs as a result of infection with HTLV-1 viruses. However, only a very small proportion of infected people actually form tropical spastic paraparesis, which then develops over the course of life. Basically, the infection with HTLV-1 takes place in the same way as with HIV .

Thus, the pathogens of tropical spastic paraparesis can be transmitted, for example, via the blood or through sexual intercourse. Doctors also observe double infections with both pathogens, both HTLV-1 and HIV. This particularly affects drug addicts who inject drugs into their veins.

Symptoms, Ailments & Signs

The typical symptoms of tropical spastic paraparesis are very similar to those of other neurodegenerative diseases . For this reason, tropical spastic paraparesis is sometimes confused with multiple sclerosis. Sometimes the disease also resembles the neurosyphilis associated with syphilis .

For example, patients with tropical spastic paraparesis suffer from muscle weakness , urinary incontinence and impaired perception . Occasionally, symptoms such as arthritis and uveitis also result from tropical spastic paraparesis . Typical complications of tropical spastic paraparesis include the development of myelopathy and incontinence .

Diagnosis & disease progression

A suitable specialist makes the diagnosis of tropical spastic paraparesis. During the consultation with the patient, the doctor tries to find out whether and when a possible infection with the HTLV-1 virus took place. Potential drug addiction should also be considered. In addition, the specialist finds out from the anamnesis whether the patient has traveled to the risk areas of tropical spastic paraparesis.

Since the typical symptoms of tropical spastic paraparesis are partly due to neurodegeneration, a neurologist is sometimes involved in diagnosing the disease. The descriptions of the patient and various clinical examinations are particularly important. Blood analyzes are central to detect the HTLV-1 virus in the person.

In this way, it is also possible to easily differentiate tropical spastic paraparesis from multiple sclerosis. Because with the latter there are no corresponding viruses in the blood of the patients. Carrying out a differential diagnosis is particularly relevant when determining tropical spastic paraparesis. The doctor clarifies whether there is multiple sclerosis. In addition, neurosyphilis can be ruled out.


The course of tropical spastic paraparesis can lead to a number of neurodegenerative complications. The frequently occurring muscle weakness results in limitations in the ability to move. The quality of life is significantly reduced and often leads to psychological suffering in those affected, which in turn is associated with complications.

Furthermore, TPS can cause incontinence. This can cause skin irritation, infection and ulcers. If perception disorders occur, there is an increased risk of accidents. In addition, complications can develop if the causative disease is not treated. In the worst case, tropical spastic paraparesis leads to permanent hearing and vision impairments. A possible secondary disease of TPS is arthritis, which develops from recurring inflammation of the joints and bones and severely restricts those affected in all their activities.

Vascular inflammation can also occur and permanently limit vision. A possible late consequence of the disease is myelopathy, which can lead to neurological problems such as numbness and unsteady gait. During treatment, the risks mainly come from the prescribed medication, which is always associated with certain side effects and interactions.

When should you go to the doctor?

In the case of this disease, the person affected must consult a doctor in any case, since it cannot heal on its own. The sooner a doctor is contacted, the better the further course of the disease. Therefore, the doctor should be contacted at the first symptoms and signs of this disease.

The doctor should be contacted if the person concerned suffers from weakness in the muscles. This can also lead to incontinence, with most patients also suffering from impaired perception. In general, the quality of life of those affected by this disease is significantly restricted and reduced. Spasms can also indicate this complaint and must be checked by a doctor.

In most cases, the disease can be diagnosed in childhood by a general practitioner or a pediatrician . Further treatment depends heavily on the exact symptoms and their severity. In many cases, psychological treatment is also necessary, in which parents and relatives can also take part.

Treatment & Therapy

A causal therapy of tropical spastic paraparesis is not yet possible. Because the HTLV-1 viruses can no longer be removed from the organism after infection. For this reason, current therapeutic measures are mainly directed against the symptoms of tropical spastic paraparesis.

Doctors also sometimes try to prevent an outbreak of tropical spastic paraparesis. Because not all HTLV-1 infected people actually develop tropical spastic paraparesis. For example, Japanese researchers have tested the effect of green tea on the development of tropical spastic paraparesis.

The idea is that an increased virus titer in the patient’s blood favors the manifestation of tropical spastic paraparesis. In fact, there has been some success, with green tea powder given in capsules reducing viral titers in some individuals. The content of the capsules corresponds to about ten cups of tea.


Prevention of tropical spastic paraparesis is possible if people avoid infection with the HTLV-1 viruses. The mode of transmission of the virus is the same as that of HIV. For example, there is an increased risk of contaminated blood supplies, the use of unclean injection needles and unprotected sexual intercourse.

Once infected with the HTLV-1 virus, the onset of tropical spastic paraparesis can probably be reduced by reducing the virus titre. Researchers are working on ways to effectively lower the virus titer.


In the case of tropical spastic paraparesis (TSP), aftercare can only be limited to alleviating or treating the symptoms of the disease. Generally the TSP is not curable. The affected person is infected with the pathogens until the end of his life.

Depending on the course of the disease and the severity of the TSP, the person affected may manifest muscle weakness, incontinence, impaired perception, arthritis and uveitis. If muscle weakness occurs, aftercare focuses on compensating for the movement restrictions. Physiotherapy or similar applications are generally not prescribed.

Muscle weakness is caused by the death of nerve cells. For mobility in everyday life, the affected person must be provided with orthopedic care (e.g. wheelchair, walking and standing aids). In individual cases, the muscle weaknesses lead to a permanent physical disability. Appropriate maintenance measures must then be initiated.

In the case of sensory disturbances and pain, the therapy that started with medication is continued during aftercare. All in all, the affected person must be given extensive neurological care even after their clinical stay. The patient’s blood must be analyzed regularly on an outpatient or clinical basis. The blood analyzes serve the disease prognosis.

Comprehensive psychological counseling and care for the affected person is essential for aftercare. Because TSP basically leads to significant restrictions in the quality of life. In addition, an urgent appeal must be made to the affected person’s common sense to rule out the transmission of his illness to other people through a corresponding behavior pattern.

You can do that yourself

If visual and sensory disturbances or other signs of a neurodegenerative disease occur, the doctor should be consulted. Although tropical spastic paraparesis is extremely rare, it can be fatal.

If the symptoms mentioned occur during a longer stay in southern Japan, Africa, South America or Central America, the trip must be interrupted. The viral disease requires treatment by a specialist in neurodegenerative disorders. Sick people should see a German doctor as quickly as possible and inform them of their suspicion.

The treatment itself is supported by rest, dietary measures and medicines from naturopathy . Patients are unable to work for at least two to four weeks. Depending on the course, the symptoms can be largely contained with timely therapy.

A change in diet , in which green tea and light foods are on the menu, also helps. Effective natural remedies are, for example, St. John’s wort or valerian . These painkillers and sedatives are best taken in consultation with a doctor. They help against the typical symptoms and can be taken with green tea, which is considered an effective antidote for tropical spastic paraparesis.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.