Tropical spastic paraparesis in the seychelles islands: A clinical and case-control neuroepidemiologic study

We confirmed the occurrence of endemic tropical spastic paraparesis (TSP) in the Seychelles. Most patients (14/21) were low-income black women. Mean age at onset was 42.8 years (range, 20 to 65). In 62%, onset and progression were slow. Complete paralysis developed in 8/21 (38%) after an evolution of 2 to 15 years. All patients had bilateral pyramidal signs. Loss of vibratory perception occurred in 6/21 (28%). A case-control study of putative risk factors failed to show significant differences. The clinical and epidemiologic features of TSP in the Seychelles appear to be similar to those described in other tropical countries. © 1987 American Academy of Neurology.