Hereditary spastic paraplegia

Last revised by Dalia Ibrahim on 22 Sep 2023

Hereditary spastic paraplegia (HSP) refers to a heterogeneous group of neurodegenerative conditions characterized by progressive degeneration of the corticospinal tracts and posterior column of the spinal cord.

In its pure phenotype, patients tend to have progressive and symmetric lower limb upper motor neuron signs, including weakness, spasticity, and hyperreflexia 9,10. However, many patients also have atypical features such as sensory signs, intellectual disability or dementia, or ataxia 9,10.

There are in excess of 70 types, with the most common types carrying an autosomal dominant pattern of inheritance 8,10. However, up to 40% of cases may be sporadic 10.

Often non-specific and variable depending on the underlying genetic type, but features can include:

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