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A Thin-skull Window Technique for Chronic Two-photon In vivo Imaging of Murine Microglia in Models of Neuroinflammation

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Acute transient inflammatory leukoencephalopathy in HIV.

E Tavazzi¹, L Magrassi, A Maccabruni

¹Department of General Neurology, IRCCS National Neurological Institute C Mondino IRCCS, via Mondino 2, 27100 Pavia, Italy. eleonora.tavazzi@mondino.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|January 15, 2011

Summary

A rare case of acute inflammatory leukoencephalopathy in an HIV+ woman, resembling ADEM, fully recovered with steroids, IVIG, and HAART. This highlights considering ADEM in HIV-related leukoencephalopathy diagnoses.

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Area of Science:

Neurology
Infectious Diseases
Neuroimmunology

Background:

HIV-related acute inflammatory leukoencephalopathy (AIL) presents with sudden neurological symptoms and brain lesions.
Diagnosis can be challenging due to varied presentations in immunocompromised individuals.

Observation:

A 31-year-old HIV+ woman developed acute cognitive decline, hemiparesis, and dysphasia.
Brain MRI revealed a large contrast-enhancing lesion; biopsy confirmed inflammation without an identified pathogen.

Findings:

The patient received steroids, gammaglobulins, and highly active antiretroviral therapy (HAART).
Complete clinical recovery and lesion resolution on follow-up MRI were observed.
The presentation mimicked acute disseminated encephalomyelitis (ADEM).

Implications:

This case suggests ADEM should be considered in the differential diagnosis of HIV-related leukoencephalopathy, even with atypical features.
HIV-related immunodeficiency may alter the typical presentation and course of neurological conditions like ADEM.
Prompt treatment with immunomodulatory therapy and HAART can lead to favorable outcomes in such cases.