a 35 y/o  man with  generalized spastisity .and  hyper reflex  DTR    from  10 years ago

with normal  mental state and ........  you can see  his mri   in attached file .

greeting

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Hi Reza .. did you rule out HTLV human T lymphotropic virus ( tropical spactic paraparesis) is possible in endemic areas - no necessary tropical.. we saw some in central Peru..hopefully help you

silver
would u PLZ give more details in Hx : acute onset or gradual, Extra pyramidal  Sx ,endemic and Family Hx , Hx  of infection , CSF findings , lab findings ...thanx

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