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MEDICC Rev 2018 04;20(2):27-31

Neurology and Neurosurgery Institute, Havana, Cuba.

From 1991 to 1993, an epidemic of optic and peripheral neuropathy-the largest of the century-broke out in Cuba, affecting more than 50,000 people. Initially the main clinical features were decreased visual acuity, central and cecocentral scotomas, impaired color vision and absence of the papillomacular bundle. Later, peripheral and mixed optic-peripheral forms began to appear. Read More

Ann Indian Acad Neurol 2016 Apr-Jun;19(2):183-7

Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.

Myeloneuropathy is a frequently encountered condition and often poses a diagnostic challenge. A variety of nutritional, toxic, metabolic, infective, inflammatory, and paraneoplastic disorders can present with myeloneuropathy. Deficiencies of vitamin B12, folic acid, copper, and vitamin E may lead to myeloneuropathy with a clinical picture of subacute combined degeneration of the spinal cord. Read More

Handb Clin Neurol 2014 ;121:1521-48

Department of Neurology, Weill Cornell Medical College, Methodist Neurological Institute, Houston, TX, USA. Electronic address:

A large number of causal agents produce spinal cord lesions in the tropics. Most etiologies found in temperate regions also occur in the tropics including trauma, herniated discs, tumors, epidural abscess, and congenital malformations. However, infectious and nutritional disorders occur with higher prevalence in tropical regions. Read More

West Indian Med J 2012 Jul;61(4):408-14

Department of Medicine, The University of the West Indies, Kingston 7, Jamaica.

This review follows the contributions of researchers from the Caribbean in improving the understanding of the disease mechanisms, clinical features and aetiology of neurological syndromes manifesting as diseases of the spinal cord and peripheral nerves. The evolution from the initial descriptions of neuropathies of presumed nutritional aetiology and later the recognition of two distinct subgroups, an ataxic neuropathy and a spastic myelopathy, are highlighted. The link between the natural history of human T-cell leukaemia/lymphoma virus type-1 (HTLV-1) infection and the immunopathogenesis of tropical spastic paraparesis is explored. Read More

Curr Opin Neurol 1998 Oct;11(5):539-44

Department of Internal Medicine, University of Texas, San Antonio, USA.

An interesting neurological syndrome, characterized by recurrent optic neuritis, cervical myelopathy from syringomyelia, paraparesis, amenorrhea-galactorrhea, and other endocrine problems, has been described among young black women in the French West Indies. The etiology remains unknown, but possible links with Devic's disease, acute disseminated encephalomyelitis, and neurotoxicity from quinolines in Annona muricata teas have been postulated. The largest epidemic of neuropathy in this century occurred in Cuba in 1991-1994. Read More

Rev Assoc Med Bras (1992) 1997 Jan-Mar;43(1):82-8

Universidade Federal de São Paulo, Escola Paulista de Medicina.

Unlabelled: The authors present two cases of polyneuropathy deficiency among Xavante indians where the sole food was rice in case 1 and almost so in case 2. The rice consumed by these indians was processed or hulled. Intoxication by cyanide from maniot or other vegetable was excluded. Read More

Mol Neurobiol 1994 Apr-Jun;8(2-3):149-53

Department of Medicine, University of the West Indies, Jamaica, West Indies.

This article summarizes the present state of knowledge of TSP/HAM as it is seen in Jamaica. It reviews the historical and clinical aspects of the disease, and shows how the discovery of HTLV-I has generated research in several countries and contributed to a better understanding of the disease. It highlights the need for continued collaboration between basic scientists and clinical neurologists in order that the dilemmas relating to therapy and pathogenicity may be successfully addressed. Read More

Am J Hum Biol 1990 ;2(4):429-438

Laboratory of Central Nervous System Studies, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892.

Human T-cell lymphotropic virus type I (HTLV-I), the first human retrovirus to be isolated, is the cause of endemic tropical spastic paraparesis (TSP). Originally, this chronic neurological disorder was described as a disease seen among blacks of low socioeconomic status living in tropical countries, and thus for many decades TSP remained a little known curiosity outside the endemic regions. The link between HTLV-I infection and TSP was made fortuitously, when antibodies to HTLV-I were found in serum and cerebrospinal fluid of TSP patients in Jamaica, Colombia, and Martinique. Read More

Trends Neurosci 1988 Dec;11(12):526-32

East Afr Med J 1988 Sep;65(9):614-20

Q J Med 1988 Apr;67(252):273-81

Department of Medicine, University of the West Indies, Kingston, Jamaica.

Rev Neurol (Paris) 1988 ;144(10):578-85

C.H.U. d'Abidjan (Côte d'Ivoire), France.

Sixty one cases of tropical myeloneuropathies (TNM) from Abidjan, Ivory Coast, are reported. The mean age of patients was 35 years. The socioeconomic level was often very low and puerperality was a common initiating factor. Read More

Bull Pan Am Health Organ 1987 ;21(3):293-305

Rev Infect Dis 1986 Sep-Oct;8(5):760-70

Late lesions of yaws are thought to be limited to skin, bones and joints, without congenital, visceral, or central nervous system (CNS) involvement. However, the treponemes isolated from patients with yaws, endemic syphilis, and venereal syphilis are genetically identical subspecies of Treponema pallidum. The controversy surrounding distinctions between syphilis and yaws is presented in its historical context, and reports of congenital, visceral, and CNS complications of yaws are reviewed. Read More

Neurology 1985 Aug;35(8):1158-70

Tropical myeloneuropathies include tropical ataxic neuropathy and tropical spastic paraparesis. These disorders occur in geographic isolates in several developing countries and are associated with malnutrition, cyanide intoxication from cassava consumption, tropical malabsorption (TM), vegetarian diets, and lathyrism. TM-malnutrition was a probable cause of myeloneuropathies among Far East prisoners of war in World War II. Read More