ABSTRACT
A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.
Subject(s)
Animals , Female , Humans , Middle Aged , Antibodies, Helminth/blood , Electron Transport Complex IV/genetics , Enzyme-Linked Immunosorbent Assay , Helminth Proteins/genetics , Histocytochemistry , Immunoglobulin G/blood , Magnetic Resonance Imaging , Molecular Sequence Data , Polyradiculopathy/pathology , Sequence Analysis, DNA , Sparganosis/diagnosis , Spine/diagnostic imaging , Spirometra/classificationABSTRACT
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