Cytomegalovirus polyradiculoneuropathy in acquired immune deficiency syndrome

Behar, Ramnik; Wiley, Clayton A.; McCutchan, J. A.

doi:10.1212/wnl.37.4.557

Cited by 136 publications

(33 citation statements)

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“…In the DSPN, mean cell count was 7.8inini" (0. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21], and mean protein level was 87 nig/lOO nil (43-189). In the IDP, pleiocytosis of the CSF ( > l o cells/nil) was found in 5 of 6 cases.…”

Section: Methodsmentioning

confidence: 99%

The spectrum of changes on 20 nerve biopsies in patients with HIV infection

et al. 1989

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Nerve and muscle biopsies were performed on 20 patients with HIV infection and peripheral neuropathy. Nine patients had distal symmetrical peripheral neuropathy (DSPN) (six ARC and three AIDS), six had inflammatory demyelinating polyneuropathy (IDP) (three ARC, one AIDS, and two otherwise asymptomatic patients), one had mononeuropathy multiplex (MM) (AIDS), 1 had mononeuropathy (ARC), one had meningoradiculitis (AIDS), and two had areflexia-associated lymphocytic meningitides (ARC), DSPN exhibited axonal degeneration in four of nine cases and was associated with segmental demyelination in five of nine cases. IDP exhibited segmental demyelination associated with axonal degeneration in four of six cases. Demyelination was more frequent in asymptomatic patients (2 of 2 cases) and in ARC (7 of 12 cases), whereas axonal degeneration was predominant in AIDS (6 of 6 cases). Mononuclear cell infiltration was seen in 1 of 2 asymptomatic patients and in 11 of 12 ARC patients but was exceptionally found in AIDS (1 of 6 cases). Involvement of the walls of small vessels, mostly venules ("subacute microvasculitis"), was found in 1 of 2 asymptomatic patients, in 8 of 12 ARC patients, and never in AIDS. The polyclonal mononuclear cell population was composed mainly of Leu 2 (T8) positive cells in seven cases of ARC. No virions were seen in electron microscopy. HIV was isolated in two cases from the CSF or the nerve biopsy.

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Section: Methodsmentioning

confidence: 99%

The spectrum of changes on 20 nerve biopsies in patients with HIV infection

et al. 1989

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“…Focal parenchymal necrosis, necrotizing ventriculoencephalitis (Wiley et al, 1986), and radioculomyelitis were seen less frequently, in three or four patients. No consistent identifiable clinical syndrome caused by CMV emerged from this pathological study except for focal neurological deficits of necrotizing radioculomyelitis (Moskowitz et al, 1984;Behar et al, 1987; see also Section 13.3). Grafe and Wiley (1989) studied the spinal cords, nerve roots, and peripheral nerves of 27 AIDS patients.…”

Section: 41 Neuropathology Of CMV Lnfection In Aids Patientsmentioning

confidence: 73%

Cytomegalovirus

1991

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All rights reserved 90-14345 CIP No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Preface to the First EditionAlthough there are a number of excellent current reviews on one or another aspect of cytomegalovirus, the last comprehensive treatment of this subject was that of Krech et al. (197la). In view of the amazing advances in the virological, epidemiologic, and clinical knowledge of cytomegaloviruses, an up-to-date book is needed. Such a work should cover many areas of expertise and a voluminous technical literature. Each area might have been reviewed and analyzed by workers more expert than myself. However, I have embarked on the entire venture alone in order to attain unity and continuity in this book, characteristics that are not easily achieved in the more popular multiauthored works. I have tried to review the Iiterature and provide a critical summary for each area discussed. To do this, I provide as much of the primary data of the relevant works as needed and not just the qualitative conclusions. Inevitably, the flow of the narrative may be interrupted by dry facts and figures. However, such information is essential to make this a meaningful reference work. But for those not interested in such details, I have provided at what I hope are crucial points critiques and summaries.This book is not an exhaustive review of all the literature. This is probably no Ionger possible or even desirable. By selection, however, one runs the risk of having missed or ignored important papers. I am keenly aware of this, and I wish to apologize for such oversight, if that is possible.I visualize this work as being useful for physicians, scientists, and students interested in the biology of and infection by human cytomegalovirus. I feel that to understand these, the basic virology of this virus and related herpesviruses must be included. Topics that have not advanced a great deal and that are adequately described in available works, such as the anatomic pathology, have not been reviewed in detail. The emphasis has been placed on newer insights in the virology, immunology, serology, epidemiology, and especially clinical aspects of human cytomegalovirus. I wish tobring out the interactions of knowledge in these areas. Part II is a much shorter treatment of the nonhuman cytomegaloviruses, reviewed primarily from the point of view of their contribution to the understanding of the human virus. V vi Preface to the First Edition Finally, I wish to thank Drs. Charles R. Rinaldo, Jr., John A. Armstrong, and Donald N. Medearis for their critical review of the manuscript. Their suggestions were invaluable. Dr. John N. Dowling's thorough review of CMV infection in patients with malignancies was the basis of Section 13.4. I also acknowledge the indispensable and patient secretarial assistance of Ms.The remarkable medical events and advances in knowle...

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“…CMV myelitis is a form of necrotizing myelitis resulting in paraplegia or tetraplegia [10], whereas poyradiculo-myeloptahy manifests with ascending are flexia, hypotonic paresis, paresthesia's and early urinary retention [17][18][19].…”

Section: Clinical Features Of CMV Encephalitismentioning

confidence: 99%