Topic 47 of 75 in the MU Plovdiv syllabus for Neurology (Medicine, Year 4). The free AceMed note covers it in 8 sections, about 934 words (7 min of reading), with 29 flashcards.
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AIDS dementia complex
Clinical features
Investigations
Diagnosis
Treatment
Cryptococcal Meningitis or Meningoencephalitis
Herpetical encephalitis
Retroviral disease of nervous system
AIDS dementia complex
In the latter stages of HIV infection
Subacute or chronic HIV encephalitis presenting as a form of dementia; generally referred to as the AIDS dementia complex, or ADC.
Clinical features
First symptoms – cognitive disorders (slowly or rapidly progressive dementia - loss of retentive memory, inattentiveness, language disorder, and apathy). Patients unable to follow conversations, taking longer to complete daily tasks, and becoming forgetful
Incoordination of the limbs and ataxia of gait
Impairment of smooth pursuit and saccadic eye movements
Heightened tendon reflexes
Babinski signs, grasp and suck reflexes
Weakness of the legs progressing to paraplegia
Bladder and bowel incontinence reflecting spinal cord or cerebral involvement
Abulia or mutism are prominent in the later stages of the disease
Investigations
CSF in patients with AIDS dementia (but lacking other manifestations of AIDS) may be normal or show only a slight elevation of protein content and, less frequently, a mild lymphocytosis. HIV can be isolated from the CSF.
CT scan shows widening of the sulci and enlargement of ventricles; MRI may show patchy but confluent or diffuse white matter changes with illdefined margins.
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