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Myelopathy and HIV infection.
T Smith1, J Jakobsen, W Trojaborg
1Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.
AIDS (London, England)
|June 1, 1990
Summary
Human Immunodeficiency Virus (HIV) infection can cause myelopathy, a spinal cord condition. Early HIV myelopathy is asymptomatic, progressing upwards from the lumbar spine, eventually causing leg weakness and ataxia.
Area of Science:
- Neurology
- Infectious Diseases
- Neurophysiology
Background:
- The clinical significance of myelopathy in Human Immunodeficiency Virus (HIV) infection remains unclear.
- HIV-associated myelopathy (HIVM) is a potential complication of HIV infection.
- Understanding the progression of HIVM is crucial for patient management.
Purpose of the Study:
- To investigate the electrophysiological progression of myelopathy in HIV-seropositive individuals.
- To determine the pattern of spinal cord involvement in early versus advanced HIV disease.
- To elucidate the relationship between electrophysiological changes and clinical symptoms.
Main Methods:
- Prospective electrophysiological follow-up study.
- Measurement of spinal-evoked potentials via tibial nerve stimulation.
- Assessment of latency changes from the gluteal crease to the 12th thoracic vertebra (T12) over a 2-year interval.
- Comparison of latency changes between HIV-seropositive men without AIDS and patients with AIDS.
Main Results:
- A 32% prolongation in latency to T12 was observed in HIV-seropositive men without AIDS after 2 years.
- In patients with AIDS, further latency prolongation proximal to T12 occurred.
- These findings suggest a rostral (upward) progression of myelopathy in HIV infection.
Conclusions:
- Myelopathy appears to be an integral, initially asymptomatic component of HIV infection.
- The disease progresses from the lumbar spinal cord upwards.
- This progression correlates with the development of clinical symptoms like leg weakness and ataxia in later stages.