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Sensory motor neuropathy associated with AIDS.
R O Bailey1, A L Baltch, R Venkatesh
1Neurology Services, Veterans Administration Medical Center, Albany, NY.
Neurology
|June 1, 1988
Summary
Peripheral neuropathy in patients with acquired immunodeficiency syndrome (AIDS) may stem directly from the human immunodeficiency virus (HIV). Further research is needed to understand the multifactorial causes of this neurological complication.
Area of Science:
- Neurology
- Virology
- Immunology
Background:
- Peripheral neuropathy is a recognized complication in patients with acquired immunodeficiency syndrome (AIDS).
- The exact etiology of peripheral neuropathy in AIDS patients remains incompletely understood, with various contributing factors proposed.
Purpose of the Study:
- To investigate the clinical, laboratory, and pathological features of sensory motor peripheral neuropathy in patients with AIDS.
- To determine the potential role of direct viral insult in the pathogenesis of peripheral neuropathy in AIDS.
Main Methods:
- Clinical assessment and laboratory testing (blood, urine, cerebrospinal fluid - CSF) were performed on six patients.
- Electrophysiological studies and peripheral nerve pathology (including electron microscopy) were utilized to evaluate nerve damage.
Main Results:
- Blood and urine tests excluded other common causes of neuropathy.
- CSF analysis revealed elevated human immunodeficiency virus (HIV)-specific indices.
- Peripheral nerve pathology demonstrated axonal loss, demyelination, and inflammatory infiltrates in some patients.
- Retroviral-like particles were observed within the axoplasm of peripheral nerves in one patient with early neuropathy.
Conclusions:
- The findings suggest that direct viral insult by HIV can be a cause of peripheral neuropathy in some AIDS patients.
- The pathogenesis of peripheral neuropathy in AIDS is likely multifactorial, involving viral, immune, and possibly other mechanisms.