THE NEUROMUSCULAR COMPLICATIONS OF HIV INFECTIONS Essay

THE NEUROMUSCULAR COMPLICATIONS OF HIV INFECTIONS - Essay Example Distal symmetric, often painful sensorimotor polyneuropathy and CMV infection are more common in the late stages of AIDS. 6. AIDP and CIDP may be the initial manifestation of disease, related to autoimmune dysfunction. CSF shows pleocytosis and increased protein. Nerve conduction studies (NCSs) and biopsy are compatible with demyelination. 7. Mononeuropathy multiplex is an inflammatory response in the early stages of disease. Late MM is typically associated with CMV infection. May appear as IDP or PP. EMG and NCS show axonal degeneration and asymmetric involvement. SDF shows pleocytosis and elevated protein level. 8. Progressive polyradiculopathy (PP) is typically associated with CMV and herpes infections. Highly active antiretroviral therapy (HAART) has reduced the incidence of PP. CSF shows pleocytosis and elevated protein level. It typically presents with a cauda equina–like picture, and EMG shows denervation of the lower extremities. NCSs are mildly slow. 10. Myopathy shows proximal weakness and is confirmed with EMG. Elevated CK may also be seen, and muscle biopsy can be helpful, demonstrating necrosis and inflammation. HIV-related myopathy must be differentiated from toxin (AZT) related myopathies. (1) Peripheral neuropathy is the commonest neurological disorder associated with HIV infection. Though symptomatic peripheral neuropathy is observed in 10% to 15% of HIV infected patients, pathologic evidence of involvement of peripheral nerve is seen almost all cases of end-stage AIDS patients. Although the pathogenesis of distal sensory polyneuropathy is unclear, the condition is associated with deterioration of the patients immune system. A primary viral etiology is unlikely, since Human Immunodeficiency Virus does not infect peripheral nerve Schwann cells or axons. The similarities in clinical and pathologic findings of HIV-associated distal sensory polyneuropathy (DSP) and vitamin B12 deficiency-related