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Cerebellitis in a human T-lymphotropic virus type 1 carrier: a case report
  1. Atsushi Mizuma,
  2. Kumiko Enokida,
  3. Eiichiro Nagata and
  4. Shunya Takizawa
  1. Department of Neurology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  1. Correspondence to Dr Atsushi Mizuma; a-mizuma{at}is.icc.u-tokai.ac.jp

Abstract

Human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with adult T-cell lymphoma (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In addition to HAM/TSP and ATL, HTLV-I-associated encephalopathy and cerebellar involvement have been reported. We report a case of an 87-year-old Japanese woman presenting with progressive dysarthria and gait disturbance. Neurological examination showed word-finding difficulty, scanning speech, saccadic eye movements, ocular dysmetria, gaze-evoked nystagmus and bilateral dysmetria. There was no motor weakness or spasticity. HTLV-I antibody was detected in both her serum and cerebrospinal fluid. Cerebrospinal fluid neopterin (57 pg/mL) and IgG index (3.27) were significantly elevated. MRI showed cerebellar swelling. She was finally diagnosed with HTLV-I associated cerebellitis. Two courses of high-dose intravenous methylpredonine therapy attenuated cerebellar ataxia and cerebellar swelling. It suggests that cerebellitis can result from HTLV-I infection, regardless of the existence of ATL or HAM/TSP.

  • infection (neurology)
  • brain stem / cerebellum

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Footnotes

  • Contributors AM described main document, KE checked laboratory findings, and EN and ST finalised document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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