Neurologic manifestations of AIDS
a review of fifty cases in Santos
Palavras-chave:
AIDS, HIV, NeurotoxoplasmosisResumo
OBJETIVO: Revisão das manifestações neurológicas de SIDA em pacientes admitidos no Hospital Guilherme Álvaro (HGA) devido a manifestações clínicas da doença. TIPO DE ESTUDO: Série de casos. PACIENTES: Todos os pacientes HIV+ admitidos no Hospital da Faculdade (HGA) entre julho de 1996 e abril de 1997 foram incluídos nesta revisão. RESULTADOS: Do total de 117 pacientes HIV+ admitidos para hospitalização por piora da sintomatologia de AIDS, 50 (42.7%) apresentavam manifestações neurológicas. A mais prevalente destas foi neurotoxoplasmose (68%), mas uma variedade de outras doenças neurológicas foi observada. Apenas 36% destes 50 pacientes apresentavam sinais e sintomas neurológicos como queixa principal na internação, 12% relatavam alguma disfunção neurológica entre suas queixas e 10% não apresentavam qualquer queixa neurológica mesmo quando questionados. Os demais 21 pacientes (42%) apenas mencionaram manifestações neurológicas quando especificamente interrogados na anamnese. CONCLUSÕES: A prevalência de manifestações neurológicas de SIDA foi bastante alta nos pacientes admitidos no hospital. Mesmo na ausência de queixas de disfunção do sistema nervoso, pacientes HIV+ devem ser sistematicamente interrogados e examinados em busca de alguma intercorrência neurológica com grande potencial de morbidade e mortalidade se não diagnosticada e tratada.
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Referências
Simpson DM, Tagliati M. Neurologic manifestations of HIV infection. Ann Inter Med 1994; 121:769-85.
Navia BA, Jordan BD, Price RW. The AIDS dementia complex: I. Clinical features. Curr Opin Psychiatry 1990; 3:96-102.
Newton HB. Common neurologic complications of HIV-1 infection and AIDS. Amer Fam Physician 1995; 51 (2):387-98.
Richman DP. Neurology of human immunodeficiency virus: past, present and future. Neurology 1995; 163:470-1.
Dismukes WE. Cryptococcic meningitis in patients with AIDS. J Infect Dis 1988; 157:624-8.
Musher, DM. Syphilis, neurosyphilis, penicillin and AIDS. J Infect Dis 1991; 163:1201-6.
Bishburg E, Sunderam G, Reichman LB, Kapila R. Central nervous system tuberculosis with the acquired immunodeficiency syndrome and its related complex. Ann Intern Med 1986; 105:210-3.
Morgello S, Cho ES, Nielsen S, Devinsky O, Petito CK. Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: an autopsy study of 30 cases and a review of the literature. Hum Pathol 1987; 18:289-97.
Bacellar H, Munoz A, Miller EN, Cohen BA, Besley D, Selnes OA, Becker JT, McArthur JC. Temporal trends in the incidence of HIV-related neurologic diseases: multicenter AIDS cohort study. Neurology 1994; 44:1892-900.
Simpson DM, Bender AN. Human immunodeficieny virus-associated myopathy: analysis of 11 cases. Ann Neurol 1988; 24:79-84.
Dalakas MC, Illa I, Pezeshkpour GH, Laukaitis JP, Cohen B, Griffin JL. Mitochondrial myopathy caused by long-term zidovudine therapy. N Engl J Med 1990; 322:1098-105.
Evans DL, Perkins DO. The clinical psychiatry of AIDS. Curr Opin Psychiatry 1990;3:96-102.
Grassi MP, Perin C, Clerici F, Zocchetti C, Borella M, Cargnel A, Mangoni A. Effects of HIV seropositivity and drug abuse on cognitive function. Eur Neurol 1997;37:48-52.
Levy RM, Rosenblum ML. Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg 1985;62:475-95.
MacArthur JC. Neurologic manifestations of AIDS. Medicine 1987;66:407-37.
Camara VD, Tavares W, Rocha MPR, Chimelli LC, Dumas-Hahn M. Contribuiçăo ao conhecimento das alteraçőes neurológicas em pacientes com SIDA. Arq Neuropsiquiatr 1995;53(1):53-9.
Porter SB, Sande MA. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med 1992;327:1643-8.
Powderly WG. Cryptococcal meningitis and AIDS. Clin Infect Dis 1993;17:837-42.
Clifford DB, Buller RS, Mohammed S, Robinson L, Storch GA. Use of polymerase chain reaction to demonstrate cytomegalovirus DNA in CSF of patients with human immunodeficiency virus infection. Neurology 1993;43:75-9.
Morgello S, Simpson DM. Multifocal cytomegalovirus demyelinative polyneuropathy associated with AIDS. Muscle Nerve 1994;17:176-82.
So YT, Olney RK. Acute lumbosacral polyradiculopathy in acquired immunodeficiency syndrome: experience in 23 patients. Ann Neurol 1994;35:53-8.
Morgello S, Block GA, Price RW, Petito CK. Varicella-zoster virus leukoencephalitis and cerebral vasculopathy. Arch Patol Lab Med 1988;112:173-7.
Cote TR, Biggar RJ, Dannenberg AL. Risk of suicide among persons with AIDS: a national assessment. JAMA 1992;268:2066-8.
Hollander H, McGuire D, Burack JH. Diagnostic lumbar puncture in HIV-infected individuals: analysis of 138 cases. Ann J Med 1994;96:223-8.
Friedmann PD, Samore MH, Kraemer KL, Calkins DR. Clinical correlates of secondary meningitis in HIV-infected adults. Arch Intern Med 1995;155:2231-7.
Mah V, Vartavarian LM, Akers MA, Vinters HV. Abnormalities of peripheral nerve in patients with human immunodeficiency virus infection. Ann Neurol 1988;24:713-7.
So YT, Holtzman DM, Abrams DI, Olney RK. Peripheral neuropathy associated with acquired immunodeficiency syndrome: prevalence and clinical features from a population-based survey. Arch Neurol 1988;45:945-8.
Breibart W, Rosenfeld BD, Passik SD, McDonald MV, Thaler H, Portenoy RK. The undertreatment of pain in AIDS ambulatory patients. Pain 1996;65:243-9.
Holloway RG, Kieburtz KD. Headache and the human immunodeficiency virus type-I infection. Headache 1995;35:245-55.
Lipton RB, Feraru ER, Weiss G, Chhabria M, Harris C, Aronow H, Newman LC, Solomon S. Headache in HIV-1 related disorders. Headache 1991;31:518-22.
Simpson DM, Bender AN, Farraye J, Mendelson SG, Wolfe DE. Human immunodeficiency virus wasting syndrome may represent a treatable myopathy. Neurology 1990; 40(3):535-8.
Siditis JJ, Price RW. Early HIV-1 infection and the AIDS dementia complex. Neurology 1990;40:323-6.
Sacktor NC, Bacellar H, Hoover DR, Nance-Sproson TE, Selnes OA, Miller EN, DalPan GJ, Kleeberger C, Brown A, Saah A, McArthur JC. Psychomotor slowing in HIV infection: a predictor of dementia, AIDS and death. J Neurovirol 1996;2:404-10.
Selnes OA, Galai N, McArthur JC, Cohn S, Royal 3rd W, Esposito D, Vlahov D. HIV infection and cognition in intravenous drug users: long-term follow-up. Neurology 1997;48:223-30.
Lopez OL, Becker JT, Banks G, Giconi J, Sanchez J, Dorst SK. Development of subtle neurological signs after systemic illness in HIV-infected individuals. Eur Neurol 1996;36:71-5.
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