NEUROLOGIC COMPLICATIONS OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION

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Abstract

BACKGROUND

Human immunodeficiency virus (HIV) results in multiple neurologic complications that are important for neurologists to understand and recognize.

REVIEW SUMMARY

Common primary complications include an encephalopathy, sometimes termed acquired immunodeficiency syndrome dementia complex, causing progressive cognitive, motor, and behavioral deterioration. A myelopathy resulting in nonfocal spinal cord dysfunction is often encountered in advanced HIV. Peripheral neuropathy, most typically a painful distal sensory neuropathy, is also frequent, whereas HIV-associated myopathy is an uncommon but important complication. These manifestations must be distinguished from opportunistic complications such as cryp-tococcal meningitis, toxoplasma encephalitis, progressive multifocal leukoencephalopathy, and cytomegalovirus-induced encephalitis and radiculomyelitis. The most common neurologic neoplastic complication is primary central nervous system lymphoma. Current pathophysiologic, diagnostic, and therapeutic strategies for these complications are reviewed.

CONCLUSION

HIV treatment and the recognition and treatment of neurologic complications are becoming increasingly successful and important. The clinician must actively consider the unique neurologic complications likely to be encountered in HIV to provide optimal care to patients with HIV.

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