HIV-related vacuolar myelopathy

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AIDS-related myelopathy
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HIV vacuolar myelopathy
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HIV-related vacuolar myelopathy
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HIV-related vacuolar myelopathy, also known as AIDS-related myelopathyis, is the most common chronic myelopathy associated with HIV infection and is typically seen in the late stages of the disease.

Clinical presentation

Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, urinary frequency and urgency 4.

Pathology

HIV infected mononuclear cells secrete neurotoxic factors. Another contributing factor may be the impaired ability to use vitamin B-12 as a source of methionine in transmethylation metabolism for myelin in the spinal cord (which may explain why findings are similar to those in subacute combined degeneration).

Radiographic features

MRI 
  • spinal cord atrophy is the most common finding, typically involving the thoracic cord; cervical cord may also be involved
  • bilateral symmetric dorsal column involvement can be seen: similar to subacute combined degeneration 1-3
  • -<p><strong>HIV vacuolar myelopathy </strong>is the most common chronic myelopathy associated with <a href="/articles/hivaids">HIV infection</a> and is typically seen in the late stages of the disease.</p><h4>Clinical presentation</h4><p>Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, urinary frequency and urgency <sup>4</sup>.</p><h4>Pathology</h4><p>HIV infected mononuclear cells secrete neurotoxic factors. Another contributing factor may be the impaired ability to use vitamin B-12 as a source of methionine in transmethylation metabolism for myelin in the spinal cord (which may explain why findings are similar to those in subacute combined degeneration).</p><h4>Radiographic features</h4><h5>MRI </h5><ul>
  • +<p><strong>HIV-related vacuolar myelopathy</strong>, also known as <strong>AIDS-related myelopathy</strong>, is the most common chronic myelopathy associated with <a href="/articles/hivaids">HIV infection</a> and is typically seen in the late stages of the disease.</p><h4>Clinical presentation</h4><p>Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, urinary frequency and urgency <sup>4</sup>.</p><h4>Pathology</h4><p>HIV infected mononuclear cells secrete neurotoxic factors. Another contributing factor may be the impaired ability to use vitamin B-12 as a source of methionine in transmethylation metabolism for myelin in the spinal cord (which may explain why findings are similar to those in subacute combined degeneration).</p><h4>Radiographic features</h4><h5>MRI </h5><ul>

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