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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Only 12 AIDS cases with hemichorea were reported in the literature. We report the first case of hemichorea associated with AIDS and cerebral toxoplasmosis in our country. A 26-year-old man had 3 episodes of focal seizures on the left side with subsequent loss of consciousness. A few weeks later, he noticed progressive left-sided weakness. Examination revealed a left hemiparesis. MRI of the head showed a round mass in the right frontal lobe and a smaller lesion in the left temporo-occipital area. Laboratory showed positive serum ELISA and Western Blot analysis for HIV antibodies. Serum tests for Toxoplasma showed elevated titers. He was treated with pyrimethamine and sulfadiazine. His weakness improved and he had no further seizures. Two weeks later, choreic movements appeared in the left foot, finally involving the entire left hemibody. A second MRI showed a new small lesion in the right cerebral peduncle. The patient completed 6 weeks of treatment, with further reduction in the size of the lesions. Nevertheless, the left hemichorea persisted. We believe that the hemichorea our patient had was caused by the contralateral peduncular lesion. Lesions involving the subthalamic nucleus or its connections may cause contralateral hemiballismus or hemichorea. In spite of the favorable response to antitoxoplasmic therapy, the hemichorea persisted. The present report illustrates an uncommon neurological complication in AIDS. We believe that a combination of a focal cerebral lesion and the HIV infection caused the movement disorder presented by the patient.
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PMID:[Hemichorea associated with cerebral toxoplasmosis and AIDS]. 854 Aug 36

The authors report a case of cystitis due to Toxoplasma Gondii infection in a patient suffering from AIDS. Initial symptoms consisted of dysuria, extreme frequency and urgent micturition responsible for pseudo urinary incontinence. Urine culture was sterile. Pelvic computed tomography and pelvic MRI demonstrated thickening of the bladder wall and seminal vesicles. Cystoscopy confirmed the presence of an intravesical proliferation with a pseudoneoplastic appearance. The diagnosis of Toxoplasma cystitis was confirmed by the discovery of Toxoplasma cysts on histological examination of bladder biopsies. Toxoplasma cystitis is a rare cause of pseudoneoplastic bullous cystitis in HIV-seropositive patients.
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PMID:[Pseudo-tumoral cystitis due to Toxoplasma in an patient with AIDS]. 771 73

Tonic seizures are a poorly understood manifestation of demyelinating disease, first reported in 4 patients with multiple sclerosis. We describe a patient with tonic extension of the left limbs caused by a right-sided brainstem lesion as the first manifestation of demyelinating disease. A 19-year-old man was referred with a 4-month history of spontaneous attacks of mild paresthesias of the left arm and leg, followed by 15-45 s of rigid extension of the left limbs, occurring up to 25 times per day. Two months after onset, an MRI scan revealed areas of T2 abnormality in the lateral right cerebral peduncle and deep frontal white matter. The EEG was normal, including during hyperventilation which induced a typical episode. All attacks were successfully suppressed by carbamazepine, phenytoin, and valproate monotherapy. Serologic testing for toxoplasmosis, cytomegalovirus, Epstein-Barr virus, Lyme disease, and HIV was negative. Cerebrospinal fluid oligoclonal bands were absent but cerebrospinal fluid immunoglobulin G was mildly elevated (4.2 mg/dl). Over the next 30 months, serial MRIs revealed a normal spinal cord and persistence of the midbrain lesion, with resolution of some of the white matter lesions but reappearance of others. At 46 months, the midbrain lesion resolved on MRI, and the spasms no longer occurred spontaneously, nor could they be elicited by hyperventilation. While two previous reports have shown internal capsule lesions to underlie the tonic spasms in demyelinating disease, this is the first report in which a brainstem lesion has been causative.
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PMID:Tonic "seizures" in a patient with brainstem demyelination: MRI study of brain and spinal cord. 788 Mar 43

We have examined 9 healthy volunteers and 63 HIV-patients (16 asymptomatic patients and 47 patients with clinical AIDS-dementia complex, ADC) by magnetic resonance spectroscopy (MRS) and imaging (MRI) on a Siemens Magnetom SP63 (1.5 T). Proton MRS of the brain was performed at 63 MHz using the PRESS sequence (echo time = 135 ms, TR = 1.6 s). Four main results have been found: (1) HIV-related encephalopathy induces significant modifications of brain metabolism analyzed by MRS and the most sensitive metabolic parameter is the N-acetyl-aspartate/Choline ratio, (2) the correlation between MRS and MRI is good in 75% of patients, (3) in 4 of the 16 neuro-asymptomatic patients (i.e. 25%) a metabolic encephalopathy was found while MRI was still normal, and (4) MR spectra describe 3 different pathological metabolic patterns in the brain of HIV patients. Two patterns might correspond to the two entities of HIV-induced lesions i.e. HIV encephalitis and HIV-related progressive leukoencephalopathy.
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PMID:Localized brain proton MRS metabolic patterns in HIV-related encephalopathies. 788 65

We present a case of PLB found in the sacrum in an HIV-seropositive patient who had low back pain radiating to the lower extremities. To the best of our knowledge this is the first report of this kind. Multiple imaging techniques, including MRI, could not reliably differentiate between neoplasm and infection. Both processes were considered since the patient was not only HIV-seropositive but also was an intravenous drug abuser and had a history of TB. The biopsy revealed diffuse large cell lymphoma typical of AIDS patients. The unusual location of PLB in our patient is a characteristic feature of lymphoma in patients with AIDS and our case should increase awareness among clinicians and radiologists of this possibility.
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PMID:Case report 836: Malignant large cell lymphoma of sacrum. 801 79

Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients (1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia) were analysed retrospectively and correlated with clinical symptoms. A total of 21 CT and 16 MRI studies were evaluated. CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: 6 lesions with a diameter of 1 cm and below were not detected on CT scans, in 5 patients the extent of lesions was underestimated. Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 67 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: 1. initial precentral demyelinisation with contralateral hemiparesis (n = 8); 2. lesions in temporo-occipital locations with visual disturbances (n = 2); 3. predominantly bilateral lesions of cerebellar white matter with ataxia (n = 4).
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PMID:[CT and MRT in progressive multifocal leukoencephalopathy (PML)]. 804 63

The neuroradiological studies (CT, MRI, angiography) in 21 children with perinatal HIV infection were reviewed retrospectively. No patient showed an intracranial mass lesion; after intravenous contrast medium application there was no case with disturbed blood-brain barrier. Common non-specific findings were atrophy and delayed myelination. In 7 cases atrophy was combined with multifocal nearly symmetric white matter lesions, which characteristically spared the U-fibres. Further findings included an intramedullary ring-shaped structure in the cervical cord, an AIDS-associated vasculopathy and symmetric calcifications in the basal ganglia. The spectrum of neuroradiological findings in paediatric AIDS patients differs from that in adults. Knowledge of these age-specific findings is important because the number of HIV-infected children is rising.
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PMID:[Neuroradiological findings in perinatally HIV-infected children]. 805 42

Three HIV-infected patients developed cranial neuropathy as the initial manifestation of an AIDS-related large cell lymphoma. All were homosexual men known to be HIV seropositive for 3 to 4.5 years. At the time of presentation for neurological disease, the CD4 T-lymphocyte count was < 400 cells/mm3 in each. Initial manifestations were retro-orbital headache and oculomotor nerve palsy in two and an abducens nerve palsy in the other. Repeatedly negative CSF cytologies and recovery of the cranial neuropathy obscured the diagnosis. These patients illustrate that cranial neuropathy with HIV infection may herald the presence of an occult large cell lymphoma. Spontaneous or corticosteroid-associated improvement of the cranial neuropathy, absence of abnormalities on brain imaging studies, and negative CSF cytologies do not exclude this diagnosis. We suggest that a diligent and repeated search for lymphoma be considered in HIV-infected patients presenting with cranial neuropathy, including repeated CSF examinations, MRI of brain and spine (T1 and T2) with and without gadolinium enhancement, chest and abdominal CT scans, and bone marrow biopsy.
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PMID:Cranial neuropathy heralding otherwise occult AIDS-related large cell lymphoma. 810 48

Seventy-six homosexual or bisexual men underwent two cranial MRI studies at a mean interval of 13 months; 23 were HIV seronegative, 41 seropositive but asymptomatic (Center for Disease Control (CDC) groups II/III), and 12 had AIDS related complex (ARC)/AIDS (CDC group IV). Agreement between two neuroradiologists was rated as very good for assessment of enlargement of ventricles and good for widening of cerebral sulci and the presence of focal lesions. For assessment of serial studies, the agreement was moderate. The prevalence of cerebral atrophy and focal white matter lesions was no higher in the asymptomatic patients (CDC group II/III) than in appropriate seronegative controls. Some patients with ARC/AIDS showed evidence of developing cerebral atrophy during the study period when serial scans were compared. The imaging evidence supports the other data obtained from this cohort, which suggest that no significant CNS involvement occurs in HIV infection before the development of ARC/AIDS.
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PMID:Serial MRI of the brain in asymptomatic patients infected with HIV: results from the UCMSM/Medical Research Council neurology cohort. 812 95

The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypointense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered.
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PMID:Central nervous system tuberculosis: MRI. 818 66


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