Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
HTLV-III/LAV-RELATED NEUROLOGICAL DISEASE
AIDS: Modern Concepts and Therapeutic Challenges. Broder S, ed. New York, Marcel Dekker, p. 263-83, 1987.. Unique Identifier : AIDSLINE ICDB/89650446 Berger JR; Resnick L; Dept. of Neurology, Univ. of Miami Sch. of Medicine, Miami, FL
Abstract:
Neurological disease resulting from human T-lymphotropic virus-III/lymphadenopathy-associated virus (HTLV-III/LAV) is reviewed, including HTLV-III/LAV neurotropism, acute neurological disease related to HTLV-III/LAV primary infection, HTLV-III/LAV encephalopathy, HTLV-III/LAV myelopathy, HTLV-III/LAV-related peripheral neuropathy, and diagnosis and treatment of HTLV-III/LAV-related disease. Neurological disease occurring in association with HTLV-III/LAV infection is extraordinarily common; published incidence figures range from 30% to 63% of patients (pts) with AIDS or AIDS-related complex. Neurological complications of HTLV-III/LAV may appear before the development of any associated immunological abnormalities. Neurological illnesses complicating HTLV-III/LAV can be divided into those that result from direct involvement of the nervous system by HTLV-III/LAV and those that are a consequence of immunosuppression. The latter include a variety of infectious complications, brain hemorrhage secondary to immune thrombocytopenia, embolic stroke secondary to marantic endocarditis, and neoplasm. As yet there are no recognized characteristics of pts with HTLV-III/LAV that predict the subsequent development of neurological illness or its nature. A 'subacute viral encephalitis' is probably the most common neurological complication of AIDS. HTLV-III/LAV encephalopathy may be mimicked clinically by metabolic derangements, other infectious illnesses, and CNS neoplasm. In pts with HTLV-III/LAV myelopathy, vitamin B-12 deficiency and syphilitic meningomyelitis should be considered in the differential diagnosis. The approach to the pt with symmetric peripheral neuropathy should include attempts to exclude metabolic and toxic etiologies such as alcohol, diabetes mellitus, vitamin deficiency, and drug or toxin exposure. No specific therapy exists for HTLV-III/LAV-related neurological disease. It is important to withdraw potentially offending medications from the pt with HTLV-III/LAV encephalopathy and address the metabolic parameters that may be complicating the neurological dysfunction. (64 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS AIDS-Related Complex/*COMPLICATIONS Encephalitis/ETIOLOGY Human HIV/*PATHOGENICITY Myelitis/ETIOLOGY Nervous System Diseases/*ETIOLOGY Opportunistic Infections/COMPLICATIONS Peripheral Nervous System Diseases/ETIOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL
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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.
