Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Human Immunodeficiency Virus (HIV)-encephalopathy (formerly AIDS Dementia Complex, or ADC) is characterized by global impairment of intellectual and cognitive functions, personality and behavioral disturbances, decreased memory, inability to concentrate, and apathy. Its motor dysfunction is manifested by impaired speech, gait, and coordination, and by psychomotor retardation. Several scientific reports indicate that ADC may be the earliest, and, at times, the only evidence of human immunodeficiency virus infection, and may present a diagnostic challenge, particularly in the aviation context. Several aviation medicine specialists have pointed out the safety questions raised by this condition when it presents in otherwise asymptomatic individuals. Since October 1985, U.S. military pilots have been tested for the presence of HIV antibody and grounded if found positive. In May 1991, the Executive Council of the Aerospace Medical Association approved a position statement that supports testing of pilots for infection by HIV, and maintains that "individuals confirmed to be infected should be found medically disqualified for flying duties." While bureaucrats delay in resolving HIV mandatory screening, HIV-encephalopathy may be precipitously brought to light, with symptoms involving ocular motor disorders such as dissociated nystagmus, gaze-evoked nystagmus, and impaired saccadic function and smooth pursuit, frequent signs of HIV cerebellar and pontomesencephalic dysfunction.
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PMID:HIV-encephalopathy: should we await a catastrophe before screening? 783 42

A clinical evaluation of visual and central oculomotor defects are presented in a series of 56 patients who were HIV carriers, of whom 47 fulfilled criteria for AIDS. Changes were detected in 22% of the asymptomatic patients (2/9), in 36% of the AIDS patients with no neurological complications and in 93% (15/16) of the AIDS patients with neurological involvement. Some changes were seen in 55% of the patients with AIDS. The commonest defects were alterations of saccadic movements and visual pursuit (35% respectively) and of opticokinetic nystagmus (28%). Only one homonymous visual defect was found. No brain stem syndromes were seen, except for one case of bilateral internuclear ophthalmoplegia. The commonest neurological complications were toxoplasmosis, the AIDS dementia complex (ADC) and multifocal leukoencephalopathy (MLP). Neuro-ophthalmological changes are described, in the literature, in 2-12%. Central oculomotor disorders, including supranuclear, nuclear and internuclear ophthalmoplegias are frequent and probably underestimated. Nystagmus is a common sign and there are isolated descriptions of flutter, opsoclonus and ocular dipping. The causes of visual and oculomotor changes reflect the incidence of parenchymatous neurological complications of AIDS. MLP is the commonest cause of change in the retrogeniculate optic pathways. Oculographic studies show changes in saccadic movements and ocular pursuit and signs of unstable visual fixation. These changes are seen in all ADC patients, in a large proportion of those without dementia and also in asymptomatic carriers, suggesting that oculography may be useful for prognosis.
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PMID:[Visual and central oculomotor disorders in patients with acquired immunodeficiency syndrome]. 906 84