ACUTE LUMBOSACRAL POLYRADICULOPATHY IN ACQUIRED-IMMUNODEFICIENCY-SYNDROME - EXPERIENCE IN 23 PATIENTS

被引:71
作者
SO, YT
OLNEY, RK
机构
[1] Department of Neurology, University of California at San Francisco, San Francisco, California
关键词
D O I
10.1002/ana.410350109
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We reviewed our experience in 23 patients with acquired immunodeficiency syndrome (AIDS) who had acute lumbosacral polyradiculopathy. The patients developed a distinctive syndrome of rapidly progressive flaccid paraparesis and areflexia that was frequently associated with sphincter disturbances. Persuasive laboratory evidence of a cytomegalovirus polyradiculopathy (polymorphonuclear pleocytosis or confirmatory cerebrospinal fluid culture) was found in 15 of the 23 patients. Treatment with ganciclovir in these patients led to clinical stabilization, although worsening during the first 2 weeks of treatment was common. Most patients with cytomegalovirus polyradiculopathy had severe residual deficits. Metastasis from systemic lymphoma accounted for the polyradiculopathy in 2 other patients. A more benign syndrome was identified in the remaining 6 patients. They generally had slower clinical progression and less severe neurological deficits at their nadir than did patients with cytomegalovirus polyradiculopathy. Unlike patients with cytomegalovirus infection, their cerebrospinal fluid showed a predominantly mononuclear pleocytosis. Moreover, spontaneous improvement without treatment was common. Our experience together with the published experience of others suggests chat the acute lumbosacral polyradiculopathy in AIDS is a clinical syndrome with different etiologies and variable clinical outcome. Recognition of this heterogeneity is necessary for the management of individual patients, as well as the interpretation of treatment results.
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页码:53 / 58
页数:6
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共 25 条
  • [1] GADOLINIUM-ENHANCED MRI IN A CASE OF CYTOMEGALOVIRUS POLYRADICULOPATHY
    BAZAN, C
    JACKSON, C
    JINKINS, JR
    BAROHN, RJ
    [J]. NEUROLOGY, 1991, 41 (09) : 1522 - 1523
  • [2] CYTOMEGALOVIRUS POLYRADICULONEUROPATHY IN ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME
    BEHAR, R
    WILEY, C
    MCCUTCHAN, JA
    [J]. NEUROLOGY, 1987, 37 (04) : 557 - 561
  • [3] BEYDOUN SR, 1991, MUSCLE NERVE, V14, P575
  • [4] CYTOMEGALOVIRUS-INFECTION OF THE CENTRAL-NERVOUS-SYSTEM IN PATIENTS WITH AIDS - DIAGNOSIS BY DNA AMPLIFICATION FROM CEREBROSPINAL-FLUID
    CINQUE, P
    VAGO, L
    BRYTTING, M
    CASTAGNA, A
    ACCORDINI, A
    SUNDQVIST, VA
    ZANCHETTA, N
    MONFORTE, AD
    WAHREN, B
    LAZZARIN, A
    LINDE, A
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1992, 166 (06) : 1408 - 1411
  • [5] NEUROLOGIC PROGNOSIS OF CYTOMEGALOVIRUS POLYRADICULOMYELOPATHY IN AIDS
    COHEN, BA
    MCARTHUR, JC
    GROHMAN, S
    PATTERSON, B
    GLASS, JD
    [J]. NEUROLOGY, 1993, 43 (03) : 493 - 499
  • [6] MAGNETIC-RESONANCE-IMAGING OF THE CAUDA-EQUINA IN CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY
    CRINO, PB
    GROSSMAN, RJ
    ROSTAMI, A
    [J]. ANNALS OF NEUROLOGY, 1993, 33 (03) : 311 - 313
  • [7] DEGANS J, 1990, J ACQ IMMUN DEF SYND, V3, P1155
  • [8] THERAPY FOR CYTOMEGALOVIRUS POLYRADICULOMYELITIS IN PATIENTS WITH AIDS - TREATMENT WITH GANCICLOVIR
    DEGANS, J
    PORTEGIES, P
    TIESSENS, G
    TROOST, D
    DANNER, SA
    LANGE, JMA
    [J]. AIDS, 1990, 4 (05) : 421 - 425
  • [9] PROGRESSIVE POLYRADICULOPATHY IN ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME
    EIDELBERG, D
    SOTREL, A
    VOGEL, H
    WALKER, P
    KLEEFIELD, J
    CRUMPACKER, CS
    [J]. NEUROLOGY, 1986, 36 (07) : 912 - 916
  • [10] GANCICLOVIR FOR LUMBOSACRAL POLYRADICULOPATHY IN AIDS
    FULLER, GN
    GILL, SK
    GUILOFF, RJ
    KAPOOR, R
    LUCAS, SB
    SINCLAIR, E
    SCARAVILLI, F
    MILLER, RF
    [J]. LANCET, 1990, 335 (8680) : 48 - 49