热带地区存在许多致病因子可导致脊髓疾病，包括与温带地区相似的病因，如外伤、脊柱骨和椎间盘损伤、肿瘤、硬膜外脓肿和先天畸形。然而，感染性和营养性疾病在热带地区的患病率较高，包括波特病，布鲁氏菌病，神经球菌感染，各种寄生虫病(如血吸虫病、神经囊虫病和嗜酸性脑膜炎)。值得注意的是，逆转录病毒HTLV-1是热带痉挛性截瘫/截肢症或TSP的病因。TSP的营养性原因包括维生素B和叶酸缺乏，而非洲地区存在konzo和热带性共济失调性脊髓神经病，以及营养不良和过度摄入含氰的苦木薯。TSP的其他毒性病因包括鹅口病和氟病。营养性脊髓病常伴有视神经和感觉神经病变，因此被称为热带性脊髓神经病。急性横贯性脊髓病，常见于疫苗接种、感染和纤维软骨核栓塞，可在任何地方发生。多发性硬化和视神经脊髓病在热带地区也存在，但患病率较温带地区低。计算机断层扫描和磁共振成像等现代影像技术的出现，已经能够更好地诊断和治疗这些疾病，这些疾病是导致死亡和残疾频发原因。本章概述了TSP，重点介绍最常见的病因，并提供诊断和有效治疗的线索。版权所有© 2023 Elsevier B.V. 保留所有权利。

A large number of causative agents can result in spinal cord disorders in the tropics including etiologies similar to those of temperate regions such as trauma, spinal bone and disc lesions, tumors, epidural abscess, and congenital malformations. Yet infectious and nutritional disorders differ in their higher prevalence in tropical regions including Pott's disease; brucellosis; neuroborreliosis; various parasitic diseases such as schistosomiasis, neurocysticercosis, and eosinophilic meningitis. Notably, the retrovirus HTLV-1 is the causeof tropical spastic paraparesis/paraplegia or TSP. Nutritional causes of TSP include vitamin B and folate deficiencies, while endemic clusters of konzo and tropical ataxic myeloneuropathy occur in Africa, along with malnutrition and excessive consumption of cyanide-containing bitter cassava. Other toxic etiologies of TSP include lathyrism and fluorosis. Nutritional forms of myelopathy are associated often with optic and sensory neuropathy, hence the name tropical myeloneuropathies. Acute transverse myelopathy, seen in association with vaccination, infections, and fibrocartilaginous embolism of the nucleus pulposus, can be ubiquitous. Multiple sclerosis and optic myelopathy occur in the tropics but with lesser prevalence than in temperate regions. The advent of modern imaging in the tropics, including computed tomography and magnetic resonance imaging, has allowed better diagnosis and treatment of these conditions that are a frequent cause of death and disability. This chapter provides an overview of TSP emphasizing the most common causes with clues to diagnosis and effective therapy.Copyright © 2023 Elsevier B.V. All rights reserved.