%0 Journal Article %T Syringohydromyelia or HTLV-I-associated myelopathy/tropical spastic paraparesis: a diagnostic challenge (case report) %A ARAšČJO %A ABELARDO DE QUEIROZ-CAMPOS %A LEITE %A ANA CLAšČDIA CELESTINO BEZERRA %A OLIVEIRA %A ANDRšŠ LUIZ DOS ANJOS DE %A AFONSO %A CRISTIANE RIBEIRO DE ALMEIDA %A PIES %A JULIANA %J Arquivos de Neuro-Psiquiatria %D 1999 %I Academia Brasileira de Neurologia - ABNEURO %R 10.1590/S0004-282X1999000200019 %X human t-cell lymphotropic virus type i (htlv-i) associated myelopathy / tropical spastic paraparesis (ham/tsp) is the most common chronic myelopathy in brazil. we present the case of a 53 year old man that fulfilled the diagnostic criteria for ham/tsp but had at the magnetic resonance imaging (mri) of the spinal cord evidences of syringohydromyelia at the c6-c7 and d2-d7 levels along with chiari type 1 malformation. the clinical picture was more typical of ham/tsp than of syringohydromyelia, which was probably asymptomatic. the present case clearly demonstrates that serology and neuroimaging should be always used together. we conclude that, specially in places where htlv-i is endemic, every patient with a spastic paraparesis, even with a radiological picture suggestive of a structural spinal cord lesion, should have a screening test for htlv-i. the clinical picture must dictate the final direction of the diagnosis. %K htlv-i %K tropical spastic paraparesis %K syringomyelia %K hydromyelia %K magnetic resonance imaging %K differential diagnosis. %U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0004-282X1999000200019&lng=en&nrm=iso&tlng=en