Hereditary spastic paraplegias (HSPs) are a group of neurodegenerative disorders which involve the corticospinal tracts and present with distinct spasticity and weakness of the lower extremities. The estimated prevalence of HSP is around 1.8/100,000 cases for both autosomal dominant and autosomal recessive types. Classification of HSP is based on inheritance pattern, clinical phenotype, and molecular pathophysiological mechanisms. The most common neuropathological sign is the axonal degeneration involving the lateral corticospinal tracts in both the cervical and thoracic spinal cord. The target of this review article is to provide a comprehensive overview of the HSP classification, neuropathology, and differential diagnosis.

遗传性痉挛性截瘫（HSP）是一组神经退行性疾病，涉及皮质脊髓束，表现出明显的痉挛和下肢无力。对于常染色体显性和常染色体隐性遗传类型，HSP的估计患病率约为1.8 / 100,000例。HSP的分类基于遗传模式，临床表型和分子病理生理机制。最常见的神经病理学症状是轴突变性，涉及颈脊髓和胸脊髓的外侧皮质脊髓束。本文的目标是提供有关HSP分类，神经病理学和鉴别诊断的全面概述。