Spinal cord syndromes in the acquired immune deficiency syndrome

Singh, Brij Mohan Kumar; Levine, Seymour; Yarrish, Robert; Hyland, Meaghen; Jeanty, D.; Wormser, Gary P.

doi:10.1111/j.1600-0404.1986.tb04605.x

Cited by 45 publications

(6 citation statements)

References 21 publications

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“…En la polirradiculopatía, se encuentran inclusiones en las células de Schwann, fibroblastos y célu-las multinucleadas, y endarteritis obliterante, así como infartos en la capa de mielina (15,21), pero no se han encontrado cuerpos de inclusión en las motoneuronas (22).…”

Section: Hallazgos Histopatológicosunclassified

Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

et al. 2017

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: descripción del caso clínico y del marco teórico sustentado durante la discusión Camilo Lara y Natalia Rueda: resumen de presentación del artículo, descripción de los aspectos radiológicos del caso clínico, sustentación de los hallazgos en imágenes descritos en casos previamente publicados Todos los autores contribuyeron a la discusión y la edición del manuscrito. El citomegalovirus (CMV) es uno de los microorganismos oportunistas con mayor prevalencia en pacientes inmunocomprometidos, aunque su reactivación ha descendido después de la introducción de la terapia antirretroviral altamente activa (Highly Active Antiretroviral Therapy, HAART). En las coinfecciones, la encefalitis se ha reportado como una de las condiciones más frecuentes. Se presenta el caso de un paciente adulto joven con infección por virus de la inmunodeficiencia humana (HIV) que tuvo un rápido deterioro neurológico evidenciado en síntomas y signos clínicos clásicos del síndrome de Wernicke-Korsakoff y que no presentaba factores de riesgo para deficiencia de tiamina. En las imágenes de la resonancia magnética cerebral, se detectaron hallazgos típicos del síndrome, y se identificó citomegalovirus (CMV) en el líquido cefalorraquídeo. Con el tratamiento específico para el CMV, se logró el control de los síntomas, aunque hubo secuelas neurológicas que mejoraron. Este es uno de los pocos casos reportados a nivel mundial de síndrome de Wernicke secundario a encefalitis por citomegalovirus. Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case reportCytomegalovirus (CMV) is one of the opportunistic microorganisms with the highest prevalence in immunocompromised patients. Reactivation has decreased after the introduction of highly active antiretroviral therapy (HAART). Encephalitis has been reported in the coinfection as one of the most frequent presentations. We present the case of a young adult patient with HIV infection and rapid neurological deterioration due to classic clinical symptoms and signs of the Wernicke-Korsakoff syndrome, with no risk factors for thiamine deficiency, with images by nuclear magnetic resonance typical of the syndrome, and identification of cytomegalovirus in cerebrospinal fluid. The specific treatment for CMV managed to control the symptoms with neurological sequelae in progression towards improvement. This is one of the few cases reported in the literature of Wernicke syndrome secondary to cytomegalovirus encephalitis. La infección por el virus de la inmunodeficiencia humana (HIV) continúa siendo una de las de mayor trascendencia en el mundo; los informes epidemiológicos internacionales indican que, si bien la incidencia ha disminuido de 2,2 millones de personas infectadas en el 2010 a 2,1 millones en el 2015, la prevalencia ha aumentado de 33,3 millones a 36,7 millones en el mismo periodo. Por otra parte, las muertes relacionadas con el sida se han reducido de 1,5 millones en el 2010 a 1,1 millones en el 2015 (26 %) (1). Ello significa que las tasas de transmisión han disminuido y que la expecta...

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Section: Hallazgos Histopatológicosunclassified

Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

et al. 2017

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“…A potential role of nutritional deficiency as the cause of spinal cord pathology has been suggested. 12 The pathogenesis of vacuolar myelopathy may be secondary to a defect in the vitamin B 12 -dependent transmethylation pathway 13 ; alternatively, a combination of immune-mediated myelin and oligodendrocyte injury and simultaneous lack of repair mechanisms due to a deficiency of S-adenosylmethionine (SAM) may be the mechanism. 14 Vacuolar myelopathy is not observed in young children with AIDS; however, pathological abnormalities of the spinal cord are frequently seen at autopsy.…”

Section: Hivmentioning

confidence: 99%

Infectious Myelopathies

Berger¹,

Sabet²

2002

Semin Neurol

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Although infectious myelopathies are rare, timely and accurate diagnosis is essential to improving outcome. There are a number of organisms that may cause infectious myelopathies, including human immunodeficiency virus (HIV), human T-cell lymphotropic virus type I (HTLV-I), herpesviruses, enteroviruses, Treponema pallidum, Mycobacterium tuberculosis, fungi, and parasites. Vacuolar myelopathy, the most common form of spinal cord disease in HIV-infected individuals, is underrecognized clinically. The failure to diagnose this condition is generally a consequence of the attribution of the lower extremity weakness and paresthesias to general debility and concomitant peripheral neuropathy. Tropical spastic paraparesis or HTLV-I-associated myelopathy involves the pyramidal tracts, chiefly at the thoracic level, and results in spastic lower extremity weakness and a spastic bladder. The herpesviruses (varicella-zoster, herpes simplex type 2, cytomegalovirus) and the enteroviruses cause myelitis. Prior to the development of antibiotics, syphilis was the most frequent infectious cause of spinal cord disease. In light of the broad spectrum of pathogens that may affect the spinal cord and the variegate fashion in which these disorders may present, the physician must always consider an infectious etiology in the differential diagnosis for the patient presenting with myelopathy. This review addresses the infectious myelopathies by microorganism.

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“…Bei einem Patienten von Möbius et al (36) zeigte sich das Bild einer hypertrophischen Neuropathie. In einem Teil der Fälle wurden entzündliche Rundzelleninfiltrate (11,14,17,30,37,43) und/oder Mikrovaskulitis (17,20,27) (4,15,17,34). Auch beim Auftreten von Rundzelleninfiltraten oder Vaskulitis kleiner epi-und endoneuraler Gefäße in Nervenwurzeln oder peripheren Nerven wurde an eine CMV-Infektion gedacht (7,17,20,37,43).…”

Section: Morphologische Befunde äTiologie Pathogeneseunclassified

Polyneuropathien bei HIV-Infektion

Neundörfer¹,

Engelhardt²,

Kf³

1989

Fortschr Neurol Psychiatr

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In approximately 10-16% of the cases, diseases of the peripheral nerves occur in the fully developed stage of AIDS, more seldom, however, in the stage of ARC. Some cases have been described in the stage of seroconversion or lymphadenopathy. At this stage cranial neuropathies can show up in connection with aseptic meningitis. The peripheral nerve diseases are present as distal symmetric sensomotory neuropathy, as chronic demyelinating polyradiculoneuropathy, as acute polyradiculoneuritis and as mononeuropathy multiplex. Frequently Varicella-zoster-radiculitis is observed. Cranial neuropathies are noted especially together with atypical aseptic meningitis, as a syndrome of the above mentioned polyneuropathies, with intracranial lymphomas and meningitides and meningoencephalitides caused by opportunistic infections. The morphological findings of the roots and nerves are variable: axonal degeneration and/or demyelination, infiltration of lymphocytes and microvasculitis. The pathogenesis varies: amongst others, direct infection by HIV, immunopathological changes and opportunistic infections are considered. The spontaneous development frequently leads to a remission. Treatment with corticosteroids and/or plasma exchange is only partially successful.

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Spinal cord syndromes in the acquired immune deficiency syndrome

Abstract: Two patients with AIDS developed paraparesis. Neuropathological post mortem examination in one revealed cytomegalovirus polyradiculopathy, and in the second, vacuolar myelopathy which occurred in association with brain lesions resembling Marchiafava-Bignami Syndrome.

Cited by 45 publications

References 21 publications

Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

Wernicke-Korsakoff syndrome secondary to cytomegalovirus encephalitis: A case report

Infectious Myelopathies

Polyneuropathien bei HIV-Infektion

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