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Neurodevelopmental delay and focal seizures as presenting symptoms of human immunodeficiency virus I infection
Insights
Human immunodeficiency virus (HIV) infection in children can cause severe neurological symptoms, including developmental regression and motor deficits. Folate metabolism derangements may contribute to these neurological complications in pediatric HIV.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroimmunology
Background:
- Neurological complications are a significant concern in pediatric human immunodeficiency virus (HIV) infection.
- Early development is typically normal, followed by progressive decline.
Observation:
- Three children with HIV presented with neurological symptoms including psychomotor regression, hypotonia, seizures, and spastic quadriplegia.
- Neuroimaging revealed abnormal brain density and basal ganglia calcification in some cases.
- Cerebrospinal fluid analysis showed reduced folate and elevated neopterin levels.
Findings:
- Pediatric HIV infection is associated with significant neurological impairment.
- Abnormalities in brain density and basal ganglia calcification are observed.
- Altered folate metabolism and elevated neopterin are linked to neurological symptoms.
Implications:
- These findings suggest a potential link between deranged folate metabolism and neurological manifestations in pediatric HIV.
- Further research into metabolic pathways may reveal novel therapeutic targets for neurological complications in HIV.
Abstract:
Three children presenting with neurological symptoms were subsequently diagnosed as being infected with the human immunodeficiency virus I (HIV). All children showed normal development for about 12-18 months of age but later developed psychomotor and developmental regression. One child presented with generalised hypotonia, another with focal seizures, and the third with spastic quadriplegia. Two of the children showed areas of abnormal brain density on computed tomography and in one case there was calcification of the basal ganglia. In two of the children cerebrospinal fluid contained reduced amounts of total folate and elevated concentrations of neopterin. The possibility of a link between the deranged folate metabolism and the neurological symptoms in HIV infection is discussed.