Central nervous system complications of human immunodeficiency virus [HIV] infection

Human immunodeficiency virus [HIV] may affect the central nervous system [CNS] directly, producing distinct neurological syndromes such as HIV-associated neurocognitive impairment [HNC I], vacuolar myelopathy, or indirectly, by causing immunodeficiency with a resultant susceptibility to opportunistic infections, neoplasms and vascular diseases. The focus of this review is to evaluate information and data on epidemiologic characteristics, clinical manifestations, pathogenetic mechanisms, investigations and therapy for CNS complications of HIV/AIDS and to outline a practical approach to assess and manage these disorders. This review does not include the peripheral neuropathies, other less common conditions associated with HIV infection, or the toxic effects of specific antiretroviral drugs

peripheral nervous system complications of HIV infection

More than half of HIV-infected persons develop symptomatic neurological disease. The nervous system is extensively involved with no part of the neuraxis being immune from the virus. HIV-associated neuropathies have become the most frequent neurological disorder associated with HIV infection. The most common forms of HIV-associated neuropathies are the distal sensory polyneuropathy [DSP] and antiretroviral toxic neuropathy. Other forms include acute or chronic inflammatory polyneuropathies. Mononeuritis multiplex or radiculopathies may occur in late stages and are mostly associated with opportunistic infections. Furthermore, HIV-related muscle involvement is an uncommon but important complication. This may be due to polymyositis, HIV-associated wasting syndrome or may be aggravated by drugs. The aim of this review is to evaluate the available data on clinical manifestations, pathogenesis, investigations and the therapeutic implication for peripheral nervous system [PNS] neuropathies complications of HIV/AIDS. This review summarises those issues that are likely to confront clinicians, including those who do not routinely treat people infected with HIV

Electrodiagnosis in the evaluation of ulnar neuropathy in Benghazi

To study the causes, clinical presentation and the findings of electrophysiological examination in patients with ulnar nerve neuropathy due to entrapment or traumatic disorders, Prospective study of patients with ulnar neuropathy referred for neurophysiological studies [nerve conduction and electromyography studies]. Cases included people aged between 15-75 years, who had ulnar nerve neuropathy and referred for electrodiagnosis in Benghazi, between March 2003 and September 2006. There were 53 patients with ulnar neuropathy, 32 were male and 21 were females. The mean age was 36 +/- 13.5 [SD] yeas [range 15-75 years]. The common clinical manifestations were weakness, sensory disturbances and pain in the ulnar nerve territory. Twenty-seven [51%] patients had traumatic ulnar neuropathy, while the other 26 [49%] patients had idiopathic compression neuropathy of the ulnar nerve at the elbow [cubital tunnel syndrome]. Axonal damage on electrophysiological examination was established in 25 [93%] cases of patients who had traumatic neuropathy. Segmental demyelination and conduction delay were observed in 20 patients with the cubital tunnel syndrome, while axonal injury was recorded in 6 patients of whom 3 were diabetic patients. Additional carpal tunnel syndrome was found in 7 patients of this group. The present study was comparable with previous reports. The obtained data were similar for male predominance, clinical and electrophysiological findings. However, the study reveals a high prevalence of stab wound injury of the ulnar nerve among young men,. This suggests that preventive strategies are indicated to prevent and combat this rising problem and hence, the devastating consequences, of functional disability