1/25. HIV infection and seizures.New-onset seizures are frequent manifestations of central nervous system disorders in patients infected with human immunodeficiency virus (HIV). seizures are more common in advanced stages of the disease, although they may occur early in the course of illness. In the majority of patients, seizures are of the generalised type. status epilepticus is also frequent. Associated metabolic abnormalities increase the risk for status epilepticus. Cerebral mass lesions, cryptococcal meningitis, and HIV-encephalopathy are common causes of seizures. phenytoin is the most commonly prescribed anticonvulsant in this situation, although several patients may experience hypersensitivity reactions. The prognosis of seizure disorders in HIV-infected patients depends upon the underlying cause.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
2/25. Localization of retrovirus in the central nervous system of a patient co-infected with HTLV-1 and HIV with HAM/TSP and HIV-associated dementia.persons co-infected with HTLV-1 and HIV are at increased risk for neurologic disease. These patients may develop HAM/TSP and/or HIV-associated dementia. In this study, we localized cells infected with retrovirus in the central nervous system (CNS) of a patient with both HAM/TSP and HIV-associated dementia. HTLV-1 was localized to astrocytes and HIV to macrophage/microglia. There was no co-infection of a single cell phenotype in this patient. These data suggest that mechanisms other than co-infection of the same CNS cell may play a role in the development of neurologic disease in patients dual infected with HTLV-1 and HIV.- - - - - - - - - - ranking = 5keywords = nervous system (Clic here for more details about this article) |
3/25. central nervous system adverse effects with efavirenz: case report and review.Efavirenz is a nonnucleoside reverse transcriptase inhibitor that can be given with other antiretroviral agents for the treatment of human immunodeficiency virus infection. A 47-year-old man with acquired immunodeficiency syndrome developed severe depression and suicidal ideation necessitating psychiatric hospitalization and antidepressant therapy. The symptoms occurred in temporal relation to the introduction of efavirenz into his highly active antiretroviral therapy regimen. Similar serious psychiatric adverse effects have been associated with this agent. Clinicians should monitor for central nervous system adverse effects in all patients taking efavirenz.- - - - - - - - - - ranking = 5keywords = nervous system (Clic here for more details about this article) |
4/25. glioblastoma multiforme of the brain stem in a patient with acquired immunodeficiency syndrome.glioblastoma of the brain stem is rare and there is no description of such a lesion in patients suffering from acquired immunodeficiency syndrome. The majority of intracerebral mass lesions are due either to toxoplasmosis or primary central nervous system lymphomas so that it is usually not included in the differential diagnosis of enhancing lesions of the central nervous system in these patients. A 31-year-old human immunodeficiency virus (HIV) infected man presented with a four months history of slowly progressive deterioration of brainstem associated symptoms despite antitoxoplasmic therapy. magnetic resonance imaging revealed a large ring enhancing lesion in the brainstem. Clinical and neuroradiological data could not establish a proper diagnosis and a stereotactic serial biopsy was undertaken. Histological examination of the specimen showed a glioblastoma multiforme (GBM) as the first reported case of GBM located in the brainstem in an acquired immunodeficiency syndrome (AIDS) patient. Patient management and effectiveness of stereotactic serial biopsy are discussed.- - - - - - - - - - ranking = 2keywords = nervous system (Clic here for more details about this article) |
5/25. Rhythmic cortical myoclonus in a case of HIV-related encephalopathy.We describe a 66-year-old, HIV-seropositive patient presenting with ataxia and upper limb rhythmic myoclonus activated by postural maintenance. Electromyograph (EMG) recordings of the forearm muscles showed 50-msec bursts, with a frequency of 10 Hz, concurring with frontocentral electroencephalograph (EEG) rhythmic activity. Autoregressive spectral analysis applied to the EEG-EMG traces made it possible to detect significant coherence between the rhythmic EEG discharges and EMG bursts. The amplitude of the middle-latency somatosensory evoked potentials was increased. Long-latency reflexes were enhanced. On the basis of the electrophysiological findings, the movement disorder should be considered a rhythmic variant of cortical myoclonus. In our patient, HIV infection may have caused a dysfunction in the central nervous system pathways involving the cerebellum and sensorimotor cortex, similar to that occurring in genetically determined conditions characterised by cortical myoclonus.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
6/25. DSM-IV mental disorders and neurological complications in children and adolescents with human immunodeficiency virus type 1 infection (hiv-1).AIM: - To study the types of psychiatric problem encountered in children infected with the human immunodeficiency virus (HIV) and their relationship to central nervous system disorder and the severity of infection. methods: - 17 HIV-infected children presenting with psychiatric problems were included. mental disorders were evaluated according to DSM-IV criteria. Neurological disorders and progressive encephalopathy (presence or absence) diagnosis were evaluated by clinical and radiological examination. The severity of infection was assessed by the percentage of CD4 lymphocytes. RESULTS: - The most frequent diagnoses were major depression (MDD: 47%) and attention deficit hyperactivity disorder (ADHD: 29%). Major depression diagnosis was significantly associated with neuroimaging or clinical neurological abnormalities (p < 0.01). In contrast, no association was found between hyperactivity diagnosed according to DSM-IV criteria and central nervous system disorder. Percentage of CD4 lymphocytes were close to 0 for more than 80% of children presenting with psychiatric complications. CONCLUSION: - The very low % of CD4 lymphocytes of these children suggest that the appearance of a psychiatric complication should be regarded as a factor indicating severe HIV infection. Depressive disorders may be a clinical form of encephalopathy.- - - - - - - - - - ranking = 2keywords = nervous system (Clic here for more details about this article) |
7/25. Excitotoxicity and dopaminergic dysfunction in the acquired immunodeficiency syndrome dementia complex. Therapeutic implications.Human immunodeficiency virus infection is frequently complicated by a syndrome of central nervous system dysfunction known as the acquired immunodeficiency syndrome dementia complex (ADC). The ADC is characterized by abnormalities in cognition, motor performance, and behavior, and it produces serious morbidity in a significant number of patients with acquired immunodeficiency syndrome. The pathogenesis of ADC is unclear, but appears to be caused by the human immunodeficiency virus itself, rather than by a secondary opportunistic process. Herein, we review the data regarding the pathogenesis of ADC and hypothesize a mechanism involving excitotoxicity and dopaminergic dysfunction. N-methyl-D-aspartate receptor antagonists may be of therapeutic benefit, as these agents may both limit glutamate-mediated neuronal dysfunction and improve dopaminergic neuronal function.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
8/25. Macrophage- and astrocyte-derived transforming growth factor beta as a mediator of central nervous system dysfunction in acquired immune deficiency syndrome.The multifunctional cytokine, transforming growth factor beta (TGF-beta), was identified by immunocytochemistry in the brain tissues of four patients with acquired immune deficiency syndrome (AIDS), but not in control brain tissue. The TGF-beta staining was localized to cells of monocytic lineage as well as astrocytes, especially in areas of brain pathology. In addition, the brain tissues from the AIDS patients contained transcripts for human immunodeficiency virus 1 (hiv-1) by in situ hybridization, suggesting a correlation between the presence of hiv-1 in the brain and the expression of TGF-beta. However, the expression of TGF-beta was not limited to hiv-1-positive cells, raising the possibility of alternative mechanisms for the induction of TGF-beta in these AIDS patients' brains. To investigate these mechanisms, purified human monocytes were infected in vitro with hiv-1 and were shown to secrete increased levels of TGF-beta. In addition, hiv-1-infected monocytes released a factor(s) capable of triggering cultured astrocytes that are not infected with hiv-1 to secrete TGF-beta. The release of TGF-beta, which is an extremely potent chemotactic factor, may contribute to the recruitment of hiv-1-infected monocytic cells, enabling viral spread to and within the central nervous system (CNS). Moreover, TGF-beta augments cytokine production, including cytokines known to be neurotoxic. The identification of TGF-beta within the CNS implicates this cytokine in the immunopathologic processes responsible for AIDS-related CNS dysfunction.- - - - - - - - - - ranking = 5keywords = nervous system (Clic here for more details about this article) |
9/25. Pathogenesis of HIV encephalitis.A wide spectrum of infectious agents attack the central nervous system (CNS) of acquired immunodeficiency syndrome (AIDS) patients. Human immunodeficiency virus (HIV) itself, infects the CNS of a subgroup of these patients. The mechanism behind why HIV enters the CNS is unclear. We have observed an interesting association between HIV and opportunistic viral infections that may explain why HIV enters the brain. Infection of the CNS by opportunistic agents results in recruitment of latently HIV-infected monocytes. Upon differentiation into macrophages these cells produce abundant HIV. Latent HIV-infection of monocytes/macrophages provides a unique opportunity for cooperativity between opportunistic infections and HIV in mediating CNS damage.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
10/25. Immunohistochemical characterization of multinucleated giant cells in the brain of a Japanese AIDS patient.In an autopsy case of a 35-year-old Japanese hemophiliac with acquired immune deficiency syndrome (AIDS), many multinucleated giant cells (MGCs) were observed throughout the central nervous system. Immunohistochemically, MGCs possessed surface and cytoplasmic macrophage antigens expressed in the late stage of differentiation indicating them to be macrophages in the terminal stage of differentiation. Fine nuclear extensions connecting one nucleus (or lobe) to another were often observed in the MGCs. This feature was interpreted as multilobulation and considered to be a morphological characteristic of MGCs in AIDS encephalopathy. Similarity between MGCs in AIDS encephalopathy and highly lobulated lymphocytes in adult T cell leukemia is discussed.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
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