Abstract Details

Title Human Immunodeficiency Virus-Associated Lumbosacral Polyradiculopathy

Topic Infections/AIDS/Prion Disease

Presentation(s) P03 - (-)

Poster/Presentation
Number 260

Objective

Background BACKGROUND: HIV infection is commonly associated with neurologic disorders. Both the direct effects and secondary complications are known to cause neurologic impairment. Fortunately, many of these complications are seen less often since the introduction of HAART. The neurologic complications of HIV are broad, and include HIV associated dementia and myelopathy, as well as neuromuscular diseases including distal symmetric polyneuropathy, inflammatory demyelinating polyneuropathy, mononeuropathies, mononeuropathy multiplex, autonomic neuropathy, and radiculopathies. HIV associated polyradiculopathies are often caused by infections such as CMV, VZV, TB, and syphilis or malignancies such as lymphoma. On extensive case review, it appears that a subacute and progressive lumbosacral polyradiculpathy as a direct result of HIV infection is rare.

Design/Methods DESIGN/METHODS: Case Report.

Results RESULTS: We present a 24 year old female with subacute onset of asymmetric lower extremity weakness and mild symmetric distal paresthesias. Extensive workup (including CSF, cytology, cytometry) for infectious, inflammatory, structural, and malignant etiologies was completed and was unrevealing except for recent diagnosis of HIV-1 infection with CD4 count of 84/mm3 and viral load of 736,000 cop/ml. Electrophysiologic evaluation demonstrated a mild, generalized, length dependent, symmetric mixed sensory and motor predominately axonal polyneuropathy, as well as chronic denervation in the right L3-L5 myotomes. Treatment with HAART alone was initiated with gradual resolution of her weakness over the following six months.

Conclusions CONCLUSIONS: This case represents the importance of considering HIV itself as a possible etiology of subacute lumbosacral polyradiculopathy.

Authors/Disclosures
Samuel J. Maiser, MD (Hennepin Healthcare) PRESENTER	Dr. Maiser has nothing to disclose.
	No disclosure on file
Shyam Prabhakaran, MD (University of Chicago)	Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.

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