HIV-related vacuolar myelopathy
Citation, DOI, disclosures and article data
At the time the article was created David Clopton had no recorded disclosures.
View David Clopton's current disclosuresAt the time the article was last revised Daniel J Bell had no recorded disclosures.
View Daniel J Bell's current disclosures- AIDS-related myelopathy
- AIDS-associated vacuolar myelopathy
- AIDS related vacuolar myelopathy
HIV-related vacuolar myelopathy, also known as AIDS-related myelopathy, is the most common chronic myelopathy associated with HIV infection and is typically seen in the late stages of the disease.
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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 B12 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
References
- 1. Chong J, Di Rocco A, Tagliati M et-al. MR findings in AIDS-associated myelopathy. AJNR Am J Neuroradiol. 1999;20 (8): 1412-6. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 2 Santosh CG, Bell JE, Best JJ. Spinal tract pathology in AIDS: postmortem MRI correlation with neuropathology. Neuroradiology. 1995;37 (2): 134-8. Pubmed citation
- 3. Sartoretti-Schefer S, Blättler T, Wichmann W. Spinal MRI in vacuolar myelopathy, and correlation with histopathological findings. Neuroradiology. 1998;39 (12): 865-9. Pubmed citation
- 4. Di Rocco A, Simpson DM. AIDS-associated vacuolar myelopathy. AIDS Patient Care STDS. 1998;12 (6): 457-61. Pubmed citation
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