Neuro-otological Manifestations in Different Stages of HIV Infection

Otoneurological findings in human immunodeficiency virus positive patients

“…10,11 Koralnik et al described altered rotational test results in 11 per cent of cases, with a 20.7 per cent occurrence of positional nystagmus, in a group of 29 HIV-positive, nonsymptomatic patients. 12 The most extensive study thus far has been by Hausler et al 13 Fifty-seven per cent of stage IV HIVpositive patients were found to suffer some vestibular alteration, with modification of pursuit, visual vestibular inhibition, and evoked bithermal and rotational nystagmus. All of these parameters were also altered in 50 per cent of stage III HIV-positive patients and 22 per cent of stage II patients.…”

Does the human immunodeficiency virus influence the vestibulocollic reflex pathways? A comparative study

“…An earlier study found slightly less abnormal caloric test results compared to the current study, namely 11.6% in their sample of subjects with HIV. 25 In contrast, only one study reported no abnormalities in caloric test findings in their sample of subjects with HIV. 24 No noticeable differences were found between the caloric test protocols employed in these reports, but the subjects in the study by Castello and colleagues 24 were all asymptomatic without any vestibular symptoms such as vertigo, dizziness or disequilibrium, which could explain the absence of abnormal caloric responses.…”

“…Hausler and colleagues 25 were asymptomatic, yet the authors reported abnormal caloric test findings even among those subjects. However, these authors did not indicate whether their subjects used ARV therapies or any medication for secondary infections that could contribute to the abnormal caloric test findings.…”

“…Three previous studies, that also used a cross-sectional research design, demonstrated an increase in vestibular involvement from early to advanced stages of the disease. 22,23,25 A detailed summary of their findings has been reviewed elsewhere. 13 There is a higher occurrence of abnormal cVEMP and caloric test findings in the advanced stages of HIV, due to the reduction in CD4+ cell counts that places the infected individual at-risk for various opportunistic infections.…”

“…20 The caloric findings in the current study could be compared with those of four previous research reports that employed a group study design of adult subjects with HIV. [22][23][24][25] The abnormal caloric test findings demonstrated the presence of abnormal functioning of the VOR pathway. Three of the four studies indicate similar abnormal caloric test findings in subjects with HIV compared to the current study (26.5%; n=9).…”