Neuromuscular complications of HIV infection and its treatment

Simpson, David M.; Wolfe, David

doi:10.1097/00002030-199108000-00001

Cited by 59 publications

(17 citation statements)

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“…Plasmapheresis generally improves the symptoms in both AIDP and CIDP. 30 HIV myopathy has no particular predilection for a given disease stage, and presents with the typical proximal weakne~s.~'.~' The occurrence of zidovudine myopathy is somewhat controversial, but is usually seen after 9 months or more of drug use. Severe myalgias are a more prominent symptom on presentation with zidovudine m y~p a t h y .~~…”

Section: W O'dellmentioning

confidence: 99%

HIV-related neurological disability and prospects for rehabilitation

O’Dell

1996

Disability and Rehabilitation

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The worldwide epidemic of acquired immunodeficiency syndrome (AIDS) continues to expand. Modest progress in prolonging survival has focused attention on the issue of quality of life among persons living with AIDS. Physical functional status (disability) is one of the most important determinants of quality of life. This paper outlines a conceptual approach to AIDS disability and provides new data examining the epidemiology of physical functional deficits in the population. In addition, the common neuromuscular and central neurological impairments encountered in AIDS are discussed with suggestions for potential rehabilitation interventions. The paper concludes with the author's view of the future of rehabilitation in persons with AIDS and human immunodeficiency virus infection.

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Section: W O'dellmentioning

confidence: 99%

HIV-related neurological disability and prospects for rehabilitation

O’Dell

1996

Disability and Rehabilitation

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“…Disorders of the peripheral nervous system occur in up to 20% of individuals with HIV infection 1 , 2 , 3 . Several different forms of neuropathy have been described 4 . The most common is a distal predominantly sensory neuropathy (DPSN), which occurs in up to 35% of individuals with advanced HIV infection 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Several different forms of neuropathy have been described 4 . The most common is a distal predominantly sensory neuropathy (DPSN), which occurs in up to 35% of individuals with advanced HIV infection 3 , 4 . Although the pathology of DPSN has been determined, primarily consisting of a retrograde distal axonal degeneration (‘dying back’ axonopathy), little is known of its pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Antibodies against peripheral myelin glycolipids in people with HIV infection

et al. 1998

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Summary Plasma samples from 35 individuals with HIV infection but without clinical peripheral neuropathy were screened by ELISA for IgM and IgG antibodies against peripheral myelin. Eighteen of the 35 samples (51%) showed IgM reactivity and 11 (31%) showed IgG reactivity. By comparison, none of 48 samples from healthy blood donors showed IgM or IgG reactivity. Epitopes reacting with these antibodies were identi®ed by TLC immunostaining as sulphatide (GalS) and the gangliosides GM 1 , GD 1a and GD 1b . Plasma samples from four people with HIV infection and neuropathy (HIV + PN), six HIV-seronegative individuals with IgM paraproteinaemic demyelinating neuropathy (IgMPDN) and 12 HIV-seronegative individuals with a variety of other neurological disorders (HIV ± OND) were also investigated. Two of the four HIV + PN samples showed IgM reactivity with GalS; and two showed IgG reactivity against GalS. Of the six IgMPDN samples, three showed IgM reactivity with GalS. These data indicate that antibodies against peripheral myelin glycolipids, in particular GalS, occur more frequently in HIV infection than in HIV-seronegative individuals with and without neurological disease, and may contribute to subclinical neuropathy in HIV infection.

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“…Many risk factors have been listed for the peripheral neuropathy found in adults with AIDS. 9,10,18,19 A small trend of a higher prevalence for peripheral neuropathy occurring in children with encephalopathy or symptomatic AIDS (CDC classifications B and C) is shown in this study. However, none of the factors presently studied had a significant correlation with the presence of symptoms and signs of peripheral neuropathy in these children, which might have been attributable to a type 2 error.…”

Section: Discussionmentioning

confidence: 46%

Distal Sensory Polyneuropathy in a Cohort of HIV-Infected Children Over Five Years of Age

2000

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ABSTRACT. Background. Peripheral neuropathy in children with human immunodeficiency virus (HIV) infection has not been systematically studied.Objectives. To describe the symptoms and signs of peripheral neuropathy in HIV-infected children and to determine their frequency.Methods. A cross-sectional study was conducted on a convenience sample from a cohort of children older than 5 years of age at the pediatric HIV outpatient clinic of the Federal University of Rio de Janeiro. Those patients were interviewed and examined systematically for peripheral nerve symptoms and signs.Results. A total of 39 patients were clinically evaluated. Their ages ranged from 5 to 14 years, and 13 patients (34%) had symptoms and signs of peripheral nerve involvement. Distal paresthesia and/or pain plus diminished ankle jerks and/or diminished vibration sense were the most common clinical findings. Symptoms were chronic and fluctuating, and pain was, in general, not severe. Nerve conduction studies primarily revealed axonal changes.Conclusions. Peripheral neuropathy occurs in one third of HIV-infected children, and, in general, has less severe features than the distal sensory polyneuropathy described in adults. Pediatrics 2000;106(3). URL: http:// www.pediatrics.org/cgi/content/full/106/3/e35; peripheral neuropathy, human immunodeficiency virus, children.ABBREVIATIONS. HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome; CDC, Centers for Disease Control and Prevention; ddI, dideoxyinosine. W orldwide, children are still becoming infected with the human immunodeficiency virus (HIV). 1 Although pediatric acquired immunodeficiency syndrome (AIDS) cases have been reported since 1983 2,3 and, soon after, many authors started to highlight the central nervous system involvement in the course of the disease, 4,5 little is known concerning these patients' peripheral nervous system status. 6,7 Peripheral neuropathy is common in HIV-infected adults, 8 -10 either related to the disease or to its treatment. It may present as inflammatory demyelinating polyneuropathy, mononeuropathy, mononeuritis multiplex, polyradiculopathy, subclinical neuropathy, or, more frequently, as distal sensory polyneuropathy.In 1991, Raphael et al 6 reported the case of a 5-year-old boy with AIDS who had developed an inflammatory demyelinating polyneuropathy. In 1997, Floeter et al 7 described the electrophysiologic data of 50 HIV-infected patients under 18 years of age referred for evaluation of suspected neuropathy. A variety of abnormalities were described, including a probable distal sensory axonal neuropathy in 7 of the oldest children. Although biased by referral, this study suggested that at least some children eventually do develop peripheral neuropathy.The epidemiology of HIV infection is evolving. More children are becoming infected, and attributable to better management strategies, they are surviving longer. The paucity of reports on peripheral neuropathy in HIV-infected children may reflect agerelated differences in regenerative capacit...

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Neuromuscular complications of HIV infection and its treatment

Cited by 59 publications

References 0 publications

HIV-related neurological disability and prospects for rehabilitation

HIV-related neurological disability and prospects for rehabilitation

Antibodies against peripheral myelin glycolipids in people with HIV infection

Distal Sensory Polyneuropathy in a Cohort of HIV-Infected Children Over Five Years of Age

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