Korean Medicine Treatment for Bilateral Lower Extremity Weakness in a Patient with Clinically Suspected HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP): A Case Report

Background: HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive myelopathy that causes gait disturbance and lower extremity weakness. Conventional treatments, including corticosteroids and immunomodulatory therapies, often provide only short-term benefit and may be associated with long-term adverse effects. This case report describes integrative Korean medicine treatment for clinically suspected HAM/TSP.Case Report: A 77-year-old woman presented with progressive bilateral lower extremity weakness and gait disturbance. Brain and whole-spine magnetic resonance imaging showed no compressive lesions, whereas somatosensory evoked potentials suggested spinal pathway involvement. Serum HTLV-1/2 antibody screening was reactive, and clinically suspected HAM/TSP was diagnosed after excluding alternative causes despite negative polymerase chain reaction results. After 91 days of integrative Korean medicine treatment centered on Gamidaebo-tang and electroacupuncture, the Osame Motor Disability Score improved from 7 to 5, the Short Physical Performance Battery score improved from 2 to 7, and the Berg Balance Scale score improved from 8 to 28, accompanied by gait recovery.Conclusion: This case suggests a potential role for integrative Korean medicine in promoting functional recovery in clinically suspected HAM/TSP.