ABSTRACT
We report a case of a 36-year-old man with a medical history of human immunodeficiency virus (HIV) infection who presented with hypomimia, hypophonia, bradykinesia, rigidity, and freezing of gait. His clinical presentation and magnetic resonance imaging were consistent with HIV encephalopathy with involvement of the bilateral basal ganglia and diffuse leukoencephalopathy. We initiated a trial of carbidopa-levodopa. The dose was escalated to 1050 mg levodopa daily. Amantadine was also started. The patient was closely monitored for behavioral, neurological, or systemic side effects. He tolerated therapy well without adverse effects. The patient's neurological status significantly improved with levodopa, including hypomimia, hypophonia, bradykinesia, and fluidity of gait. This case demonstrates that carbidopa-levodopa can be safely utilized to manage parkinsonism in an adult patient with HIV encephalopathy.
Subject(s)
AIDS Dementia Complex/drug therapy , Amantadine/therapeutic use , Antiparkinson Agents/therapeutic use , Carbidopa/administration & dosage , Gait Disorders, Neurologic/etiology , Hypokinesia/etiology , Levodopa/administration & dosage , Adult , Carbidopa/therapeutic use , Drug Combinations , Humans , Leukoencephalopathies , Levodopa/therapeutic use , Male , Treatment OutcomeABSTRACT
Acute renal failure of an abdominal aortic aneurysm is associated with an extremely poor chance of survival. We reviewed the cases of ruptured abdominal aortic aneurysm presenting between January 1, 1976 and June 1, 1979. Four patients developed oliguric acute renal failure and required hemodialysis. All patients survived despite multiple life-threatening complications. The prognosis for acute renal failure after ruptured abdominal aortic aneurysm is better than previously recognized.
