Magnetic resonance imaging (MRI) of the brain and electroencephalography (EEG) were carried out for patients with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). Nineteen of 22 patients (86%) had abnormalities on brain MRI and/or EEG. Thirteen patients showed high signal intensity lesions scattered in the cerebral white matter, as seen on the T2-weighted MRI images. The lesions were mostly located in the subcortical and deep cerebral white matter and were not contiguous with the lateral ventricles. Patients with abnormalities on the brain MRI had a longer duration of disease and a greater disability than did those without MRI abnormalities. The EEG records showed definite abnormalities in 9, and minor abnormalities in 5. All patients with HAM for more than 5 years showed definite evidence of cerebral involvement. Our findings strongly suggest that a multifocal pathological process over the entire CNS is probably a common occurrence in HAM.
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