ABSTRACT
The human immunodeficiency virus causes serious, progressive and irreversible deterioration of the immunocompetence system and of the nervous system, so neurological pathology in infected patients is frequent (30-40%), affecting both the central and the peripheral nervous systems. There are different clinical and laboratory indicators of bad prognosis, considering the important neurotropism of the virus. This study attempts to evaluate which neurophysiological parameters are altered during the initial phases of infection by HIV. A total of 46 individuals were studied, 30 seronegative and 16 seropositive in stage A of the CDC-93 classification. Motor and sensory conduction studies were carried out on all of them on the upper and lower extremities, as well as visual, somatosensory and auditory evoked potentials and endogenous potentials, mainly P300. The analysis of the neurophysiological parameters evaluated in our series, showed alterations of the conduction velocity of the sural nerve, latency of N1 of the SSEP of median and posterior tibial nerves and P300 in the initial phases of the infection even in the absence of clinical symptomatology.
Subject(s)
HIV Infections/complications , HIV-1 , Nervous System Diseases/etiology , Adult , Case-Control Studies , Disease Progression , Electrophysiology , Evoked Potentials , Female , HIV Infections/physiopathology , HIV Seronegativity , Humans , Male , Middle Aged , Motor Neurons/physiology , Nervous System Diseases/physiopathology , Neural Conduction , Peripheral Nervous System Diseases/etiology , Peripheral Nervous System Diseases/physiopathologyABSTRACT
Objetivo: Conocer incidencia, etiología y métodos diagnósticos de la patología vascular isquémica (PIV) en adultos menores de 45 años. Método: Estudio retrospectivo de 48 pacientes y análisis de factores de riesgo, etiopatogenia y exploraciones realizadas. Resultados: Se analizaron 35 hombres y 13 mujeres con una edad media de 37 años. Los principales mecanismos etiológicos fueron: aterosclerosis (22,91 por ciento), cardioembolismo (8,32 por ciento), vascular no aterosclerótica (8,32 por ciento), microangiopática (20,83 por ciento), migrañosa (6,24 por ciento), hematológica (4,16 por ciento) y desconocido (29,16 por ciento). Conclusión: Nuestros datos son similares a los reflejados en la literatura. La aterosclerosis es la causa más frecuente de PIV actuando el tabaquismo como factor coadyuvante. Tras una exhaustiva búsqueda etiológica un 30 por ciento de pacientes quedan sin diagnosticar (AU)
Subject(s)
Adult , Female , Male , Humans , Brain Ischemia/diagnosis , Brain Ischemia/etiology , Retrospective Studies , Incidence , Risk Factors , Ticlopidine/administration & dosage , Treatment Outcome , Brain Ischemia/drug therapyABSTRACT
INTRODUCTION AND OBJECTIVE: The human immunodeficiency virus (HIV) causes serious, irreversible, progressive deterioration of the immune and nervous systems. The main target cells are the 'helper' T lymphocytes and monocyte-macrophage cells with CD4 molecules on the surface acting as virus receptors. In this study we attempt to find whether the immune state and the nervous system are involved in parallel, or whether, on the contrary, HIV neurotropism is such that it leads to early nerve involvement, out of proportion to that of the immune system. PATIENTS AND METHODS: We studied a total of 66 persons, 30 seronegative and 36 seropositive, with different CD4 lymphocyte counts. In all cases motor and sensory conduction studies were done in the arms and legs, namely auditory, visual and somatosensory evoked potentials and also endogenous potentials (mainly P300). CONCLUSIONS: There are neurophysiological parameters which give pathological figures, even when immunity is maintained (figures of CD4 greater than 500/mm3) especially with regard to the figures for sensitivity of the legs, somatosensory evoked potentials and P300. Moreover, these are increased and others added at the same time as the CD4 count falls as the disease advances.
