Neurologic manifestations of human immunodeficiency virus infections

HIV infection is becoming more common. The recognition of HIV-related neurologic disease is also increasing. Both the central and peripheral nervous systems are affected by HIV infection. Although much of the pathophysiology remains to be elucidated, some of the neurologic syndromes are probably due to direct HIV infection. The most common CNS syndrome, the subacute encephalopathy, appears to be caused by HIV infection. Other cerebral syndromes are caused by viral, fungal, and protozoan opportunistic infections. Current specific therapy is available for many of these infections. Aside from zidovudine, only experimental therapies are currently available for primary HIV infection. Less attention has been focused on the neuromuscular complications of HIV infection. They are probably more common than initially reported. Specific therapies for both inflammatory demyelinating neuropathies and myopathy related to HIV infection are reported. The pathophysiology of these disorders remains incompletely defined. As the population of HIV infected individuals continues to grow, the incidence of coincidental non-HIV neurologic disease will also rise. Attention must be directed to identifying coexistent remediable causes of neurologic dysfunction in this population.