CENTRAL AND PERIPHERAL NERVOUS SYSTEM COMPLICATIONS OF HIV INFECTION AND AIDS

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

CENTRAL AND PERIPHERAL NERVOUS SYSTEM COMPLICATIONS OF HIV INFECTION AND AIDS

AIDS: Etiology, Diagnosis, Treatment, and Prevention. Second Edition. DeVita VT Jr et al, eds. Philadelphia, Lippincott, p. 185-97, 1988.. Unique Identifier : AIDSLINE ICDB/89650907
Brew B; Rosenblum M; Price RW; Memorial Sloan-Kettering Cancer Center, New York, NY

Abstract: The neurologic complications of HIV infection, and particularly its late phase, AIDS, are both common and varied, and contribute importantly to patient (pt) morbidity and mortality. Both the CNS and peripheral nervous system (PNS) are affected by a spectrum of disorders, some of which can occur as early as the period of acute HIV infection, although most occur as infection progresses to its terminal stages. Neurologic complications of HIV infection and AIDS are described, including disorders known or suspected to be due to direct infection of the CNS by HIV (emphasizing the AIDS dementia complex), CNS opportunistic infections, CNS opportunistic neoplasms, other CNS disorders, and PNS and skeletal muscle disorders. Toxoplasmosis, cryptococcal meningitis, cytomegalovirus, progressive multifocal leukoencephalitis (PML), cerebral tuberculosis, and varicella zoster and herpes simplex viruses are opportunistic infections affecting the CNS, whereas primary CNS lymphoma and lymphoma metastatic to the CNS (usually meninges) are opportunistic CNS neoplasms. A general approach to diagnosis and management of nervous system complications of HIV infection or AIDS follows that of neurologic diagnosis in general, but takes into account the particular vulnerabilities of these pts. Diagnosis includes neurologic history, neurologic examination, neuroimaging with computerized tomography, magnetic resonance imaging or other methods, cerebrospinal fluid analysis, neuropsychological testing, electrodiagnosis, therapeutic trial (toxoplasmosis), and brain biopsy (brain lymphoma and PML). These evaluations, when pursued with a background understanding of the spectrum of neurologic disorders affecting these pts, allows exact neurologic diagnosis in the majority of HIV-infected and AIDS pts. (101 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Brain Diseases/*ETIOLOGY Brain Neoplasms/ETIOLOGY Dementia/ETIOLOGY Human HIV/*PATHOGENICITY Lymphoma/ETIOLOGY Neuropsychological Tests Opportunistic Infections/COMPLICATIONS Peripheral Nervous System Diseases/*ETIOLOGY Spinal Cord Diseases/ETIOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL

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