Progressive peripheral and central sensory tract lesion in HIV-infected patients evidenced by evoked potentials

Husstedt, Ingo W.; Evers, Stefan; Reichelt, D.; Sprinz, A; Riedasch, M.; Grotemeyer, Karl-Heinz

doi:10.1016/s0022-510x(98)00132-4

Cited by 4 publications

(9 citation statements)

References 15 publications

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“…Bei klar abgrenzbarer distal-symmetrischer, HIV-assoziierte Polyneuropathie besteht keine Indikation zur Lumbalpunktion. Die ᭤Biopsie des N. suralis ist nur bei dem seltenen Verdacht auf eine Vaskulitis indiziert [9,10,14].…”

Section: Labor-und Liquoruntersuchung Biopsieunclassified

“…Einer Malnutrition kommt neben den direkten Effekten des HI-Virus im peripheren Nervensystem sicherlich Bedeutung zu. Die verminderte Produktion von Wachstumsfaktoren und die Produktion neurotoxischer Zytokine scheint einen hohen pathogenetischen Stellenwert zu besitzen [9,10,14].…”

Section: äTiopathogeneseunclassified

“…Sie können auch krankheitsbedingte muskuläre Spannungszustände wesentlich lindern und sind leicht durch den Patienten selbst erlernbar. Tabelle 4 stellt medikamentöse Therapieverfahren, Interaktionen und unerwünschte Wirkungen dar [8,9,10,11,12,13,14].…”

Section: Therapieunclassified

“…Dieses trifft insbesondere für die Antiretrovirustatika Didanosin, Zalcitabin, Lamivudin, Stavudin zu [8,9,10,11,12,13,14].…”

Section: Differenzialdiagnose Iatrogen Ausgelöste Oder Verstärkte Polunclassified

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Schmerztherapie bei HIV-assoziierter Polyneuropathie

Husstedt¹,

Böckenholt²,

Kammer-Suhr³

et al. 2001

Der Schmerz

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Only some patients with HIV-infection receive an adequate pain therapy. In later stages of HIV-infection up to 50% 6 of patients perform extraordinary doctor visits because of pain. Principally primary and secondary neuromanifestations of HIV-infection have to be differentiated. Rare forms of HIV-associated polyneuropathies represent mononeuropathy or mononeuritis multiple acute and chronic inflammatory demyelinating polyneuropathy and polyneuropathy caused by opportunistic infections. HIV-associated distal-symmetric polyneuropathy represents the most common form during HIV-infection with a prevalence up to 50%. Typical clinical symptoms and signs are pain, hyp- and dysaesthesia, diminuted deep tendon reflexes, motor deficits and autonomic disturbances. Always neurological examination and neurophysiologic investigation on the sural and peronaeal nerve are necessary for monitoring progression of polyneuropathy and as basics before starting antiretroviral therapy with neurotoxic substances. According to momentary opinion, HIV-associated distal-symmetric polyneuropathy represents no indication for antiretroviral therapy. Symptomatic therapy includes antiepileptic medication as gabapentine, antidepressive drugs as amitiptyline and additionally retarded opiates. Depressive disorders ma y accentuate pain problems a n d need psychotherapeutic and thymoleptic therapy. Special problems occur when neurotoxic substances evoke or deteriorate polyneuropathy. In these cases an individual therapeutic proceeding about continuation or discontinuation of neurotoxic medication is necessary. Symptoms of myopathy during HIV-infection are muscle pain, elevation of CK and typical changes of motor units detected by electromyography. In most cases biopsy is necessary for diagnosis of specific forms of HN-associated myopathy. HIV-associated polymyositis is treated by non-steroid analgetics, corticoids, immunoglobulines and plasmapheresis, myopathy induced by neurotoxic medication analogous to polyneuropathy.

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Section: Labor-und Liquoruntersuchung Biopsieunclassified

Section: äTiopathogeneseunclassified

Section: Therapieunclassified

“…Dieses trifft insbesondere für die Antiretrovirustatika Didanosin, Zalcitabin, Lamivudin, Stavudin zu [8,9,10,11,12,13,14].…”

Section: Differenzialdiagnose Iatrogen Ausgelöste Oder Verstärkte Polunclassified

See 2 more Smart Citations

Schmerztherapie bei HIV-assoziierter Polyneuropathie

Husstedt¹,

Böckenholt²,

Kammer-Suhr³

et al. 2001

Der Schmerz

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“…Therefore, it is not possible to differentiate between function of the PNS and the CNS. 38 Restored function of the CNS has been described after treatment with zidovudine, 39 and regression of MRI white matter signal abnormalities was recently demonstrated in patients receiving treatment with protease inhibitors. 13,37 Adding to the complexity is the observed association between HIV-1related myelopathy and DSP, 15 as well as studies using evoked potentials revealing dysfunction of both peripheral and central sensory pathways.…”

Section: Temporal Pattern Of Improvement Of Dwts and Dctsmentioning

confidence: 99%