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Myelopathies in HIV Infection

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Book cover Spinal Cord Disease

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Abstract

Myelopathies are seen clinically in about 7% of AIDS cases (McArthur 1987; Guiloff et al. 1988) and pathologically in 40%-50% of AIDS post mortems (Henin et al. 1992) but they are far less frequent in children (Sharer et al. 1990). The commonest is vacuolar myelopathy, an entity of unknown aetiology. Other myelopathies include infection by HIV-1, opportunistic infections, tumours, vascular lesions and myelopathies unrelated to HIV disease. Overall these other myelopathies are, as a group, as frequent as vacuolar myelopathy. Reasons for the lower clinical than pathological incidence include coexisting peripheral nerve or intracranial disease masking the signs of myelopathy, absence of clinical signs in cases with mild or moderate pathological change and failure to make the clinical diagnosis of vascular myelopathy in cases without weakness or spasticity or without the typical combination of pyramidal and posterior column signs.

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References

  • Berger JR (1992) Spinal cord syphilis associated with human immunodeficiency virus infection: a treatable myelopathy. Am J Med 92:101–103

    Article  PubMed  CAS  Google Scholar 

  • Britton CB, Mesa-Tejada R, Fenoglio CM, Hays AP, Garvey GG, Miller JR (1985) A new complication of AIDS: thoracic myelitis caused by herpes simplex virus. Neurology 35:1071–1074

    PubMed  CAS  Google Scholar 

  • Budka H, Maier H, Pohl P (1988) Human immunodeficiency virus in vacuolar myelopathy of the acquired immunodeficiency syndrome. N Engl J Med 319:1667–1668

    Article  PubMed  CAS  Google Scholar 

  • Chretien F, Gray F, Lescs MC et al. (1993) Acute varicella-zoster virus ventriculitis and meningo- myelo-radiculitis in acquired immunodeficiency syndrome. Acta Neuropathol 86:659–665

    Article  PubMed  CAS  Google Scholar 

  • Cohen BA, McArthur JC, Grohman S, Patterson B, Glass JD (1993) Neurologic prognosis of cytomegalovirus polyradiculomyelopathy in AIDS. Neurology 43:493–499

    PubMed  CAS  Google Scholar 

  • de Gans J, Portegies P, Tiessens G, Troost D, Danner SA, Lange JM (1990) Therapy for cytomegalovirus polyradiculomyelitis in patients with AIDS: treatment with ganciclovir. Aids 4:421–425

    Article  PubMed  Google Scholar 

  • Denning DW, Anderson J, Rudge P, Smith H (1987) Acute myelopathy associated with primary infection with human immunodeficiency virus. Br Med J 294:143–144

    Article  CAS  Google Scholar 

  • Devinsky O, Cho E-S, Petito CK, Price RW (1991) Herpes zoster myelitis. Brain 114:1181–1196

    Article  PubMed  Google Scholar 

  • Dickson DW, Belman AL, Park YD et al. (1989) Central nervous system pathology in pediatric AIDS: an autopsy study. APMIS Suppl. 8:40–57

    PubMed  CAS  Google Scholar 

  • Dodson D (1990) Transverse myelitis and spastic paraparesis in a patient with HIV infection. N Engl J Med 322:1322

    PubMed  CAS  Google Scholar 

  • Fairley CK, Wodak J, Benson E (1992) Spinal cord toxoplasmosis in a patient with human immunodeficiency virus infection. Int J STD AIDS 3:366–368

    CAS  Google Scholar 

  • Fenelon G, Gray F, Scaravilli F et al. (1991) Ischaemic myelopathy secondary to disseminated intravascular coagulation in AIDS. J Neurol 238:51–54

    Article  PubMed  CAS  Google Scholar 

  • Fuller GN, Gill SK, Guiloff RJ et al. (1990) Ganciclovir for lumbosacral polyradiculopathy in AIDS. Lancet 335:48–49

    Article  PubMed  CAS  Google Scholar 

  • Geny C, Gherardi R, Boudes P, Lionnet F, Cesaro P, Gray F (1991) Multifocal multinucleated giant cell myelitis in an AIDS patient. Neuropathol Appl Neurobiol 17:157–162

    Article  PubMed  CAS  Google Scholar 

  • Goldstick L, Mandybur TI, Bode R (1985) Spinal cord degeneration in AIDS. Neurology 35:103–106

    PubMed  CAS  Google Scholar 

  • Gräfe MJ, Wiley CA (1989) Spinal cord and peripheral nerve pathology in AIDS: the roles of cytomegalovirus and human immunodeficiency virus. Ann Neurol 25:561–566

    Article  PubMed  Google Scholar 

  • Guiloff RJ, Fuller GN, Roberts A et al. (1988) Nature, incidence and prognosis of neurological involvement in the acquired immunodeficiency syndrome in central London. Postgrad Med J 64:919–925

    Article  PubMed  CAS  Google Scholar 

  • Harris TM, Smith RR, Bognanno JR, Edwards MK (1990) Toxoplasmic myelitis in AIDS: gadolinium- enhanced MR. J Comput Assist Tomogr 14:809–811

    Article  PubMed  CAS  Google Scholar 

  • Henin D, Smith TW, De Girolami U, Sughayer M, Hauw JJ (1992) Neuropathology of the spinal cord in the acquired immunodeficiency syndrome. Hum Pathol 23:1106–1114

    Article  PubMed  CAS  Google Scholar 

  • Herskovitz S, Siegel SE, Schneider AT, Nelson SJ, Goodrich JT, Lantos G (1989) Spinal cord toxoplasmosis in AIDS. Neurology 39:1552–1553

    PubMed  CAS  Google Scholar 

  • Horoupian DS, Pick P, Spigland I et al. (1984) Acquired immune deficiency syndrome and multiple tract degeneration in a homosexual man. Ann Neurol 15:502–505

    Article  PubMed  CAS  Google Scholar 

  • Kamin SS, Petito CK (1991) Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients. Hum Pathol 22:816–824

    Article  PubMed  CAS  Google Scholar 

  • Kayser C, Campbell R, Sartorious C, Bartlett M (1990) Toxoplasmosis of the conus medullaris in a patient with hemophilia A-associated AIDS. Case report. J Neurosurg 73:951–953

    Article  PubMed  CAS  Google Scholar 

  • Klein P, Zientek G, VandenBerg SR, Lothman E (1990) Primary CNS lymphoma: lymphomatous meningitis presenting as a cauda equina lesion in an AIDS patient. Can J Neurol Sci 17:329–331

    PubMed  CAS  Google Scholar 

  • Lanska MJ, Lanska DJ, Schmidley JW (1988) Syphilitic polyradiculopathy in an HIV-positive man. Neurology 38:1297–1301

    PubMed  CAS  Google Scholar 

  • Leger JM, Henin D, Belec L et al. (1992) Lymphoma-induced polyradiculopathy in AIDS: two cases. J Neurol 239:132–134

    Article  PubMed  CAS  Google Scholar 

  • Mahieux F, Gray F, Fenelon G et al. (1989) Acute myeloradiculitis due to cytomegalovirus as the initial manifestation of AIDS. J Neurol Neurosurg Psychiatry 52:270–274

    Article  PubMed  CAS  Google Scholar 

  • Maier H, Budka H, Lassmann H, Pohl P (1989) Vacuolar myelopathy with multinucleated giant cells in the acquired immune deficiency syndrome (AIDS). Light and electron microscopic distribution of human immunodeficiency virus (HIV) antigens. Acta Neuropathol 78:497–503

    Article  PubMed  CAS  Google Scholar 

  • McArthur JC (1987) Neurologic manifestations of AIDS. Medicine 66:407–437

    Article  PubMed  CAS  Google Scholar 

  • McArthur JC, Griffin JW, Cornblath DR et al. (1990) Steroid-responsive myeloneuropathy in a man dually infected with HIV-1 and HTLV-I. Neurology 40:938–944

    PubMed  CAS  Google Scholar 

  • Mehren M, Burnes PJ, Mamani F, Levy CS, Laureno R (1988) Toxoplasmic myelitis mimicking intramedullary spinal cord tumour. Neurology 38:1648–1650

    PubMed  CAS  Google Scholar 

  • Melhem ER, Wang H (1992) Intramedullary spinal cord tuberculoma in a patient with AIDS. Am J Neuroradiol 13:986–988

    PubMed  CAS  Google Scholar 

  • Miller RG, Storey JR, Greco CM (1990) Ganciclovir in the treatment of progressive AIDS-related polyradiculopathy. Neurology 40:569–574

    PubMed  CAS  Google Scholar 

  • Moskowitz LB, Hensley GT, Chan JC, Gregorios J, Conley FK (1984) The neuropathology of acquired nimmune deficiency syndrome. Arch Pathol Lab Med 108:867–872

    PubMed  CAS  Google Scholar 

  • Overhage JM, Greist A, Brown DR (1990) Conus medullaris syndrome resulting from Toxoplasma gondii infection in a patient with the acquired immunodeficiency syndrome. Am J Med 89:814–815

    Article  PubMed  CAS  Google Scholar 

  • Petito CK, Navia BA, Cho ES, Jordan BD, George DC, Price RW (1985) Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. N Engl J Med 312:874–879

    Article  PubMed  CAS  Google Scholar 

  • Petito CK, Vecchio D, Chen YT (1994) HIV antigen and DNA in AIDS spinal cords correlate with macrophage infiltration but not with vacuolar myelopathy. J Neuropathol Exp Neurol 53:86–94

    Article  PubMed  CAS  Google Scholar 

  • Poon TP, Tchertkoff V, Pares GF, Masangkay AV, Daras M, Marc J (1992) Spinal cord toxoplasma lesion in AIDS: MR findings. J Comput Assist Tomogr 16:817–819

    Article  PubMed  CAS  Google Scholar 

  • Rance NE, McArthur JC, Cornblath DR, Landstrom DL, Griffin JW, Price DL (1988) Gracile tract degeneration in patients with sensory neuropathy and AIDS. Neurology 38:265–271

    PubMed  CAS  Google Scholar 

  • Rhodes RH, Ward JM (1989) Immunohistochemistry of human immunodeficiency virus in the central nervous system and an hypothesis concerning the pathogenesis of AIDS meningoencephalomyelitis. Progr Aids Pathol 1:167–179

    CAS  Google Scholar 

  • Rosenblum MK, Brew BJ, Hahn B et al. (1992) Human T-lymphotropic virus type I-associated myelopathy in patients with the acquired immunodeficiency syndrome. Hum Pathol 23:513–519

    Article  PubMed  CAS  Google Scholar 

  • Sharer LR, Dowling PC, Michaels J et al. (1990) Spinal cord disease in children with HIV-1 infection: a combined molecular biological and neuropathological study. Neuropathol Appl Neurobiol 16:317–331

    Article  PubMed  CAS  Google Scholar 

  • Snider WD, Simpson DM, Nielsen S, Gold JW, Metroka CE, Posner JB (1983) Neurological complications of the acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol 14:403–418

    Article  PubMed  CAS  Google Scholar 

  • Tan SV, Guiloff RJ, Scaravilli F (1995) AIDS-associated vacuolar myelopathy. A morphometric study. Brain 118:1247–1261

    Article  PubMed  Google Scholar 

  • Tan SV, Guiloff RJ, Henderson DC et al. (1996) AIDS-associated vacuolar myelopathy and tumor necrosis factor-alpha (TNFa). J Neurol Sci 138:134–144

    Article  PubMed  CAS  Google Scholar 

  • Tucker T, Dix RD, Katzen C, Davis RL, Schmidley JW (1985) Cytomegalovirus and herpes simplex virus ascending myelitis in a patient with acquired immune deficiency syndrome. Ann Neurol 18:74–79

    Article  PubMed  CAS  Google Scholar 

  • Tyor WR, Glass JD, Baumrind N et al. (1993) Cytokine expression of macrophages in HIV-1-associated vacuolar myelopathy. Neurology 43:1002–1009

    PubMed  CAS  Google Scholar 

  • Vinters HV, Guerra WF, Eppolito L, Keith PE (1988) Necrotizing vasculitis of the nervous system in a patient with AIDS-related complex. Neuropathol Appl Neurobiol 14:417–424

    Article  PubMed  CAS  Google Scholar 

  • Vinters HV, Kwok MK, Ho HW et al. (1989) Cytomegalovirus in the nervous system of patients with the acquired immune deficiency syndrome. Brain 112:245–268

    Article  PubMed  Google Scholar 

  • von Einsiedel RW, Fife TD, Aksamit AJ et al. (1993) Progressive multifocal leukoencephalopathy in AIDS: a clinicopathologic study and review of the literature. J Neurol 240:391–406

    Article  Google Scholar 

  • Woods GL, Goldsmith JC (1990) Aspergillus infection of the central nervous system in patients with acquired immunodeficiency syndrome. Arch Neurol 47:181–184

    PubMed  CAS  Google Scholar 

  • Woolsey RM, Chambers TJ, Chung HD, McGarry JD (1988) Mycobacterial meningomyelitis associated with human immunodeficiency virus infection [see comments]. Arch Neurol 45:691–693

    PubMed  CAS  Google Scholar 

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Authors
  1. R. J. Guiloff
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Editors and Affiliations

  1. Department of Neurology, Royal Preston Hospital, Sharoe Green Lane, Preston, PR2 4HT, UK

    Edmund Critchley DM, FRCP

  2. Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada

    Andrew Eisen MD, FRCP(C)

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© 1997 Springer-Verlag London Limited

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Guiloff, R.J. (1997). Myelopathies in HIV Infection. In: Critchley, E., Eisen, A. (eds) Spinal Cord Disease. Springer, London. https://doi.org/10.1007/978-1-4471-0911-2_19

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  • DOI: https://doi.org/10.1007/978-1-4471-0911-2_19

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1233-4

  • Online ISBN: 978-1-4471-0911-2

  • eBook Packages: Springer Book Archive

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