Understanding Hereditary Spastic Paraplegia

A Comprehensive Guide for Patients and Families

Neurology

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Last updated: Mar 24, 2025

Overview

Hereditary spastic paraplegia (HSP) is a group of inherited neurological disorders characterized by progressive stiffness and weakness in the legs. This condition primarily affects the lower body due to the gradual deterioration of nerve fibers that control leg movement.

Key Symptoms

  • Progressive leg stiffness (spasticity)
  • Weakness in leg muscles
  • Difficulty walking
  • Balance problems
  • Muscle spasms
  • Foot deformities

Types of HSP

Pure HSP

  • Primarily affects leg movement
  • Minimal involvement of other neurological functions

Complex HSP

  • Includes additional neurological symptoms
  • May affect:
    • Cognitive function
    • Vision
    • Hearing
    • Speech

Inheritance Patterns

  • Autosomal dominant: One affected parent can pass the condition
  • Autosomal recessive: Both parents must carry the gene
  • X-linked: Passed through the X chromosome

Diagnosis

  1. Clinical examination
  2. Detailed family history
  3. Genetic testing
  4. MRI scans
  5. Neurological assessments

Treatment Options

Physical Therapy

  • Stretching exercises
  • Strength training
  • Balance exercises
  • Gait training

Medications

  • Muscle relaxants
  • Anti-spasticity drugs
  • Pain management medications

Supportive Devices

  • Ankle braces
  • Walking aids
  • Orthopedic shoes

Living with HSP

Daily Management

  • Regular exercise routine
  • Proper posture maintenance
  • Fall prevention strategies
  • Home modifications

Long-term Outlook

  • Variable progression rate
  • Many maintain independent mobility
  • Regular medical monitoring needed

Support Resources

  • Genetic counseling
  • Support groups
  • Physical therapy services
  • Occupational therapy

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