Infection with human T cell lymphotropic virus type I (HTLV-I) causes multiple neurologic disorder , due to the retroviruses.Spinal cord disease of this type is named TSP (tropical spastic paraparesis) that were drawn to the attention of
   neurologists 45 years ago. The clinical picture is one of the slowly progressive paraparesis with increased tendon reflexes & Babinski signs ; disorder of sphincteric control is usually an early change. Paresthesia , reduced vibratory & position senses, & ataxia have been described. The diagnosis is confirmed by the detection the
   antibodies to the virus in serum . There are anecdotal reports of improvement with IV-administration of gammaglobulin. But HTLV₁-infection has other clinical manifestations. This report presents a rare case with bilateral facial weakness as primary manifestation.

This case is related to a 41 years old woman. The clinical picture was bilateral facial weekness and approximately after 2 months, she referred to hospital with myelitis. In primary exams and evaluation, the diagnose was HTLV-I infection. The diagnosis  was confirmed by the detection of the antibodies against the virus in her
   serum. She dead after 2.5 months of the first sign due to disease severity and bulbar palsy.

Possible transmission routes and the risk of encountering the disease outside endemic areas must be attended , and it is recommended to evaluate antibodies in the children of the patients.