Os autores apresentam 10 casos de provável paraparesia espástica tropical (PET) oriundos do Nordeste do Brasil (Hospital das Clínicas - Universidade Federal do Ceará). Os sintomas consistem de fraqueza dos membros inferiores, marcha espástica, hiperreflexia, disfunção esfincteriana e sinais variados de distúrbio proprioceptivo. Outras etiologias de mielopatias foram excluídas pelos exames complementares. A idade dos pacientes ia de 21 a 59 anos, todos eram da raça negra e havia discreto predomínio de mulheres. Recentemente, tem-se atribuído ao retrovírus HTLV-I a etiologia da PET. Por falta de condições técnicas ainda não pudemos determiná-la em nossos pacientes.

Ten possible cases of tropical spastic paraparesis (TSP) in Northeastern Brazil (Ceará) are presented. They show the typical symptoms and signs of TSP consisting of weakness of the lower limbs, spastic gait, hiperreflexia, bladder dysfunction and variable signs of posterior columns impairment. The laboratory examinations excluded other compressive, infective, degenerative or demyelinating lesions of their spinal cord. Our patients age ranged from 21 to 59 years, all were of black origin and all were of lower social class. There was a slight preponderance of females. An etiological implication of a retrovirus (HTLV-I) has been shown for TSP, but for lack of technical conditions we could not determine it in our patients, and that stands as our subsequent step in those and further cases.

A síndrome de Holmes-Adie consiste de pupila tônica, arreflexia patelar e disfunção autonômica. As explicações desses diferentes sintomas têm-se baseado em achados neuropatológicos e eletrofisiológicos. Neste trabalho apresenta-se uma hipótese imunológica para a fisiopatogenia da síndrome, de modo semelhante ã da síndrome de Guillain-Barré.

The Holmes-Adie syndrome consists of pupillotonia, arreflexia and autonomic dysfunction. Some explanations for these different symptoms have been attempted, centred upen neuropathological and electrophysiological findings. A hypothetical immunemediated mechanism, as in the Guillain Barré syndrome, is presented in this paper for explaining the three chief symptoms of the syndrome.