HIV-related vacuolar myelopathy
Updates to Article Attributes
HIV vacuolar myelopathy is the most common chronic myelopathy associated with HIV infection, and is typically seen in the late stages of HIV infection.
Clinical presenation
Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, and urinary frequency and urgency 4.
Pathophysiology
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
olumn invovlementcolumn 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 title="HIV infection" href="/articles/hiv-infection">HIV infection</a>, and is typically seen in the late stages of HIV infection.</p><h4>Clinical presenation</h4><p><span style="color:rgb(0, 0, 0); font-family:arial,helvetica,clean,sans-serif; line-height:17px">Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, and urinary frequency and urgency <sup>4</sup>.</span></p><h4>Pathophysiology</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>-<li><p>spinal cord atrophy is the most common finding - typically involving the thoracic cord; cervical cord may also be involved.</p></li>-<li><p>bilateral symmetric dorsal olumn invovlement can be seen - similar to <a href="/articles/sub-acute-combined-degeneration-of-the-cord">sub acute combined degeneration</a><sup> 1-3</sup></p></li>- +<p><strong>HIV vacuolar myelopathy </strong>is the most common chronic myelopathy associated with <a href="/articles/hiv-infection">HIV infection</a>, and is typically seen in the late stages of HIV infection.</p><h4>Clinical presenation</h4><p>Patients tend to have slowly progressive weakness of the lower extremities, gait disorders, sensory abnormalities in the lower limb, impotence, and urinary frequency and urgency <sup>4</sup>.</p><h4>Pathophysiology</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>
- +<li>spinal cord atrophy is the most common finding, typically involving the thoracic cord; cervical cord may also be involved</li>
- +<li>bilateral symmetric dorsal column involvement can be seen: similar to <a href="/articles/subacute-combined-degeneration-of-the-cord-1">subacute combined degeneration</a><sup> 1-3</sup>
- +</li>
Systems changed:
- Spine
- Central Nervous System
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