Abstract
The acquired immune deficiency syndrome (AIDS) is a syndrome requiring unique knowledge of its versatile manifestations for accurate diagnosis and skillfull management of its numerous complications for successful treatment. The human T-cell lymphotropic virus type III (HTLV-III), a replication-complete virus, is now reported as the etiologic agent. The neurologic complications of AIDS cover the spectrum of neurologic diseases and usually have multiple causative factors, all of which should be appropriately managed. These complications can be successfully treated, although constant monitoring is required because recurrence is frequent. The neurologic complications are the second most frequent cause of death in AIDS patients.
Tests that are usually reliable in diagnosing neurologic diseases may not be reliable in patients with AIDS. The management of AIDS is a multidisciplinary effort, and the neurologist should fulfill a role in the management team.
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- Bennett J. E., Dismukes W. E., Duma R. J., Medoff G., Sande M. A., Gallis H., Leonard J., Fields B. T., Bradshaw M., Haywood H. A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptoccal meningitis. N Engl J Med. 1979 Jul 19;301(3):126–131. doi: 10.1056/NEJM197907193010303. [DOI] [PubMed] [Google Scholar]
- Blum L. W., Chambers R. A., Schwartzman R. J., Streletz L. J. Progressive multifocal leukoencephalopathy in acquired immune deficiency syndrome. Arch Neurol. 1985 Feb;42(2):137–139. doi: 10.1001/archneur.1985.04060020047014. [DOI] [PubMed] [Google Scholar]
- Centers for Disease Control (CDC) Update on acquired immune deficiency syndrome (AIDS)--United States. MMWR Morb Mortal Wkly Rep. 1982 Sep 24;31(37):507-8, 513-4. [PubMed] [Google Scholar]
- Cole-Beuglet C., Goldberg B. B. New high-resolution ultrasound evaluation of diseases of the thyroid gland. A review article. JAMA. 1983 Jun 3;249(21):2941–2944. [PubMed] [Google Scholar]
- Curran J. W., Morgan W. M., Hardy A. M., Jaffe H. W., Darrow W. W., Dowdle W. R. The epidemiology of AIDS: current status and future prospects. Science. 1985 Sep 27;229(4720):1352–1357. doi: 10.1126/science.2994217. [DOI] [PubMed] [Google Scholar]
- Daul C. B., deShazo R. D. Acquired immune deficiency syndrome: an update and interpretation. Ann Allergy. 1983 Sep;51(3):351–361. [PubMed] [Google Scholar]
- Dyck P. J. Current concepts in neurology. The causes, classification, and treatment of peripheral neuropathy. N Engl J Med. 1982 Jul 29;307(5):283–286. doi: 10.1056/NEJM198207293070504. [DOI] [PubMed] [Google Scholar]
- Eidelberg D., Sotrel A., Vogel H., Walker P., Kleefield J., Crumpacker C. S., 3rd Progressive polyradiculopathy in acquired immune deficiency syndrome. Neurology. 1986 Jul;36(7):912–916. doi: 10.1212/wnl.36.7.912. [DOI] [PubMed] [Google Scholar]
- Farrell D. F. The EEG in progressive multifocal leukoencephalopathy. Electroencephalogr Clin Neurophysiol. 1969 Feb;26(2):200–205. doi: 10.1016/0013-4694(69)90211-9. [DOI] [PubMed] [Google Scholar]
- Fauci A. S. The acquired immune deficiency syndrome. The ever-broadening clinical spectrum. JAMA. 1983 May 6;249(17):2375–2376. [PubMed] [Google Scholar]
- Frederick W. R., Epstein J. S., Gelmann E. P., Rook A. H., Armstrong G. R., Djeu J. Y., Jackson L., Manischewitz J. F., Enterline J., Jacob J. Viral infections and cell-mediated immunity in immunodeficient homosexual men with Kaposi's sarcoma treated with human lymphoblastoid interferon. J Infect Dis. 1985 Jul;152(1):162–170. doi: 10.1093/infdis/152.1.162. [DOI] [PubMed] [Google Scholar]
- Gill P. S., Levine A. M., Meyer P. R., Boswell W. D., Burkes R. L., Parker J. W., Hofman F. M., Dworsky R. L., Lukes R. J. Primary central nervous system lymphoma in homosexual men. Clinical, immunologic, and pathologic features. Am J Med. 1985 May;78(5):742–748. doi: 10.1016/0002-9343(85)90277-3. [DOI] [PubMed] [Google Scholar]
- Goldstick L., Mandybur T. I., Bode R. Spinal cord degeneration in AIDS. Neurology. 1985 Jan;35(1):103–106. doi: 10.1212/wnl.35.1.103. [DOI] [PubMed] [Google Scholar]
- Harris A. A., Segreti J., Levin S. Central nervous system infections in patients with the acquired immune deficiency syndrome (AIDS). Clin Neuropharmacol. 1985;8(3):201–210. doi: 10.1097/00002826-198509000-00001. [DOI] [PubMed] [Google Scholar]
- Hauser W. E., Luft B. J., Conley F. K., Remington J. S. Central-nervous-system toxoplasmosis in homosexual and heterosexual adults. N Engl J Med. 1982 Aug 19;307(8):498–499. doi: 10.1056/nejm198208193070814. [DOI] [PubMed] [Google Scholar]
- Ho D. D., Rota T. R., Schooley R. T., Kaplan J. C., Allan J. D., Groopman J. E., Resnick L., Felsenstein D., Andrews C. A., Hirsch M. S. Isolation of HTLV-III from cerebrospinal fluid and neural tissues of patients with neurologic syndromes related to the acquired immunodeficiency syndrome. N Engl J Med. 1985 Dec 12;313(24):1493–1497. doi: 10.1056/NEJM198512123132401. [DOI] [PubMed] [Google Scholar]
- Ho J. L., Poldre P. A., McEniry D., Howley P. M., Snydman D. R., Rudders R. A., Worthington M. Acquired immunodeficiency syndrome with progressive multifocal leukoencephalopathy and monoclonal B-cell proliferation. Ann Intern Med. 1984 May;100(5):693–696. doi: 10.7326/0003-4819-100-5-693. [DOI] [PubMed] [Google Scholar]
- Hooper D. C., Pruitt A. A., Rubin R. H. Central nervous system infection in the chronically immunosuppressed. Medicine (Baltimore) 1982 May;61(3):166–188. doi: 10.1097/00005792-198205000-00004. [DOI] [PubMed] [Google Scholar]
- INH in multiple sclerosis. Neurology. 1984 Jan;34(1):134–135. [PubMed] [Google Scholar]
- Kolata G. Where is the AIDS virus harbored. Science. 1986 Jun 6;232(4755):1197–1197. [PubMed] [Google Scholar]
- Koppel B. S., Wormser G. P., Tuchman A. J., Maayan S., Hewlett D., Jr, Daras M. Central nervous system involvement in patients with acquired immune deficiency syndrome (AIDS). Acta Neurol Scand. 1985 May;71(5):337–353. doi: 10.1111/j.1600-0404.1985.tb03211.x. [DOI] [PubMed] [Google Scholar]
- Levy R. M., Pons V. G., Rosenblum M. L. Central nervous system mass lesions in the acquired immunodeficiency syndrome (AIDS). J Neurosurg. 1984 Jul;61(1):9–16. doi: 10.3171/jns.1984.61.1.0009. [DOI] [PubMed] [Google Scholar]
- Mildvan D., Mathur U., Enlow R. W., Romain P. L., Winchester R. J., Colp C., Singman H., Adelsberg B. R., Spigland I. Opportunistic infections and immune deficiency in homosexual men. Ann Intern Med. 1982 Jun;96(6 Pt 1):700–704. doi: 10.7326/0003-4819-96-6-700. [DOI] [PubMed] [Google Scholar]
- Millard P. R. AIDS: histopathological aspects. J Pathol. 1984 Aug;143(4):223–239. doi: 10.1002/path.1711430402. [DOI] [PubMed] [Google Scholar]
- Moskowitz L. B., Hensley G. T., Chan J. C., Gregorios J., Conley F. K. The neuropathology of acquired immune deficiency syndrome. Arch Pathol Lab Med. 1984 Nov;108(11):867–872. [PubMed] [Google Scholar]
- Nielsen S. L., Petito C. K., Urmacher C. D., Posner J. B. Subacute encephalitis in acquired immune deficiency syndrome: a postmortem study. Am J Clin Pathol. 1984 Dec;82(6):678–682. doi: 10.1093/ajcp/82.6.678. [DOI] [PubMed] [Google Scholar]
- Obeso J. A., Luquin M. R. Bromocriptine and lisuride in dystonias. Neurology. 1984 Jan;34(1):135–136. doi: 10.1212/wnl.34.1.135. [DOI] [PubMed] [Google Scholar]
- Peters A. C., Versteeg J., Bots G. T., Boogerd W., Vielvoye G. J. Progressive multifocal leukoencephalopathy: immunofluorescent demonstration of simian virus 40 antigen in CSF cells and response to cytarabine therapy. Arch Neurol. 1980 Aug;37(8):497–501. doi: 10.1001/archneur.1980.00500570045006. [DOI] [PubMed] [Google Scholar]
- Petito C. K., Navia B. A., Cho E. S., Jordan B. D., George D. C., Price R. W. Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. N Engl J Med. 1985 Apr 4;312(14):874–879. doi: 10.1056/NEJM198504043121402. [DOI] [PubMed] [Google Scholar]
- Pitlik S. D., Fainstein V., Bolivar R., Guarda L., Rios A., Mansell P. A., Gyorkey F. Spectrum of central nervous system complications in homosexual men with acquired immune deficiency syndrome. J Infect Dis. 1983 Oct;148(4):771–772. doi: 10.1093/infdis/148.4.771. [DOI] [PubMed] [Google Scholar]
- Post M. J., Chan J. C., Hensley G. T., Hoffman T. A., Moskowitz L. B., Lippmann S. Toxoplasma encephalitis in Haitian adults with acquired immunodeficiency syndrome: a clinical-pathologic-CT correlation. AJR Am J Roentgenol. 1983 May;140(5):861–868. doi: 10.2214/ajr.140.5.861. [DOI] [PubMed] [Google Scholar]
- Quinnan G. V., Jr, Masur H., Rook A. H., Armstrong G., Frederick W. R., Epstein J., Manischewitz J. F., Macher A. M., Jackson L., Ames J. Herpesvirus infections in the acquired immune deficiency syndrome. JAMA. 1984 Jul 6;252(1):72–77. [PubMed] [Google Scholar]
- Rodgers-Johnson P., Gajdusek D. C., Morgan O. S., Zaninovic V., Sarin P. S., Graham D. S. HTLV-I and HTLV-III antibodies and tropical spastic paraparesis. Lancet. 1985 Nov 30;2(8466):1247–1248. doi: 10.1016/s0140-6736(85)90778-0. [DOI] [PubMed] [Google Scholar]
- Ruskin J., Remington J. S. Toxoplasmosis in the compromised host. Ann Intern Med. 1976 Feb;84(2):193–199. doi: 10.7326/0003-4819-84-2-193. [DOI] [PubMed] [Google Scholar]
- Salaki J. S., Louria D. B., Chmel H. Fungal and yeast infections of the central nervous system. A clinical review. Medicine (Baltimore) 1984 Mar;63(2):108–132. doi: 10.1097/00005792-198403000-00004. [DOI] [PubMed] [Google Scholar]
- Shaw G. M., Harper M. E., Hahn B. H., Epstein L. G., Gajdusek D. C., Price R. W., Navia B. A., Petito C. K., O'Hara C. J., Groopman J. E. HTLV-III infection in brains of children and adults with AIDS encephalopathy. Science. 1985 Jan 11;227(4683):177–182. doi: 10.1126/science.2981429. [DOI] [PubMed] [Google Scholar]
- Snider W. D., Simpson D. M., Aronyk K. E., Nielsen S. L. Primary lymphoma of the nervous system associated with acquired immune-deficiency syndrome. N Engl J Med. 1983 Jan 6;308(1):45–45. doi: 10.1056/NEJM198301063080112. [DOI] [PubMed] [Google Scholar]
- Snider W. D., Simpson D. M., Nielsen S., Gold J. W., Metroka C. E., Posner J. B. Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol. 1983 Oct;14(4):403–418. doi: 10.1002/ana.410140404. [DOI] [PubMed] [Google Scholar]
- Waterson A. P. Acquired immune deficiency syndrome. Br Med J (Clin Res Ed) 1983 Mar 5;286(6367):743–746. doi: 10.1136/bmj.286.6367.743. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Welch K., Finkbeiner W., Alpers C. E., Blumenfeld W., Davis R. L., Smuckler E. A., Beckstead J. H. Autopsy findings in the acquired immune deficiency syndrome. JAMA. 1984 Sep 7;252(9):1152–1159. [PubMed] [Google Scholar]
- Ziegler J. L., Beckstead J. A., Volberding P. A., Abrams D. I., Levine A. M., Lukes R. J., Gill P. S., Burkes R. L., Meyer P. R., Metroka C. E. Non-Hodgkin's lymphoma in 90 homosexual men. Relation to generalized lymphadenopathy and the acquired immunodeficiency syndrome. N Engl J Med. 1984 Aug 30;311(9):565–570. doi: 10.1056/NEJM198408303110904. [DOI] [PubMed] [Google Scholar]
- Zuger A., Louie E., Holzman R. S., Simberkoff M. S., Rahal J. J. Cryptococcal disease in patients with the acquired immunodeficiency syndrome. Diagnostic features and outcome of treatment. Ann Intern Med. 1986 Feb;104(2):234–240. doi: 10.7326/0003-4819-104-2-234. [DOI] [PubMed] [Google Scholar]