A Rare Case of Hereditary Spastic Paraplegia: Case Report and Literature Review

Abstract

Hereditary spastic paraplegia (HSP) is a rare neurodegenerative disorder presenting as lower limb spasticity having two clinical types and various modes of inheritance. A young male patient presented with bilateral lower limb weakness of one-year duration showing both sensory and motor abnormalities on examination. MRI of brain and spine done as part of workup revealed marked atrophy of anterior corpus callosum with abnormal signal intensity at tips of frontal horns of ventricles mimicking the appearance of the ear of a Eurasian lynx. No other abnormality was encountered in the brain or spinal cord in our case. Other imaging abnormalities which can be encountered in such a case include periventricular and central white matter changes as well as spinal cord atrophy. Pathologically this condition is recognised by degeneration of lateral and posterior columns of the spinal cord. The differential diagnosis includes structural, metabolic, neurodegenerative, motor and nutritional deficiency disorders.