Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
CENTRAL NERVOUS SYSTEM DYSFUNCTION IN ACQUIRED IMMUNODEFICIENCY SYNDROME
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 29-63, 1988.. Unique Identifier : AIDSLINE ICDB/89648462 Levy RM; Bredesen DE; Dept. of Neurosurgery, Northwestern Univ. Medical Sch., 707; Fairbanks Court, Suite 811, Chicago, IL 60611
Abstract:
About 10% of all patients (pts) with AIDS first present with a neurological complaint that leads to a diagnosis of AIDS. Nearly 40% of all AIDS pts develop neurological symptoms during their lifetimes, and neuropathological abnormalities are found at autopsy in 75% of AIDS pts. CNS diseases associated with AIDS are discussed, including the incidence of AIDS-related neurological illness; CNS syndromes (frequency, clinical profile, and diagnosis); AIDS-related CNS diseases (primary viral infection [HIV encephalopathy, atypical aseptic meningitis, and vacuolar myelopathy]; opportunistic viral infection [progressive multifocal leukoencephalopathy and other viral infections]; nonviral infections [Toxoplasma gondii, Cryptococcus neoformans, Candida albicans, Aspergillus fumigatus, Coccidioides immitis, Mycobacterium tuberculosis, and M avium-intracellulare]; bacterial infections [Listeria monocytogenes, Nocardia asteroides, and other bacterial infections]; neoplasms [primary CNS lymphoma, metastatic Kaposi's sarcoma, and systemic lymphoma with CNS involvement]; cerebrovascular complications; and CNS complications as a result of AIDS therapy); and multiple intracranial neuropathologies. The clinical, radiological, and serological findings in AIDS pts with neurological illness are nonspecific, and there is too much overlap in clinical findings to permit the diagnosis of AIDS-related neurological illness on the basis of clinical examination. The differential diagnosis of AIDS-related neurological illness is complicated by the presence of multiple CNS illnesses. Multiple treatable illnesses have been identified in the same intracranial lesion and in different lesions, both simultaneously and sequentially. Following a pt's complaint of neurological dysfunction or neurological abnormality, a careful workup involving magnetic resonance imaging or computerized tomography brain scanning and cerebrospinal fluid examination is indicated. Diligence in evaluating response to therapy, with possible repetition of diagnostic evaluation, is necessary to deal with multiple treatable intracranial illnesses. (186 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PHYSIOPATHOLOGY AIDS-Related Complex/PHYSIOPATHOLOGY Brain Neoplasms/PHYSIOPATHOLOGY Central Nervous System/PHYSIOPATHOLOGY Central Nervous System Diseases/ETIOLOGY/*PHYSIOPATHOLOGY Human Lymphoma/PHYSIOPATHOLOGY Opportunistic Infections/ETIOLOGY/PHYSIOPATHOLOGY Syndrome MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
