The Effect of Combination Therapy with Sodium Valproate, Peg-Interferon and Prednizolone on Clinical Findings in HTLV-1 associated Spastic Paraparesis (HAM/TSP) Patients

Affection to Human T Lymphocytic Virus-type 1 (HTLV-1) in 3% of carriers results in HTLV-1 associated Myelopathy or Tropical Spastic Paraparesis (HAM/TSP) with motor، sensory and sphincteric signs. Although، chronic inflammation of spinal cord plays a critical role in this disease، immunomodulatory treatments could not show an acceptive improvement in its symptoms yet. This study was performed to evaluate the effect of sodium valproate، in combination with Peg-Interferon and prednizolone on clinical findings in patients with HAM/TSP. In a clinical trial study conducted between September and December 2012، HAM/TSP screening was done for patients referred to the neurology clinic of Qaem hospital، Mashhad. 10 patients with inclusion criteria were underwent a triple treatment with sodium valproate، Peg-Interferon and prednizolone for 3 months. The clinical signs were assessed with Osame motor disability scale، Ashworth spasticity scale and checklist of urinary signs، before and after the treatment. Pretreatment mean Osame scores in remaining 10 patients was 2. 4±1. 9، which improved 0. 8 in 70% of patients at the end of treatment (P=0. 003). Ashworth and urinary frequency scores also showed a significant improvement (P=0. 001، and P=0. 024 respectively). Our data revealed a significant improvement in motor disability and spasticity in undertreated patients. The authors have reached to a lower or same score of Osme criteria in each patient and higher improvement percentages of all studied population، if compared to IFN based mono-therapy studies. Therefore، the role of sodium valproate in improvement of motor signs in patients with HAM/TSP needs to more investigations.