Neuromuscular diseases associated with human immunodeficiency virus infection.
The types of neuromuscular diseases associated with human immunodeficiency virus (HIV) infection are described. Our classification includes: (1) six subtypes of peripheral neuropathies--namely, acute Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, mononeuritis multiplex, an axonal, predominantly sensory, painful polyneuropathy, a sensory ataxic neuropathy due to ganglioneuronitis, and an inflammatory polyradiculoneuropathy presenting as cauda equina syndrome; (2) inflammatory myopathies (e.g., polymyositis); and (3) other less common neuromuscular manifestations, such as type II muscle fiber atrophy and nemaline myopathy. Although the exact incidence of clinical and subclinical neuromuscular diseases in HIV-positive and acquired immunodeficiency syndrome (AIDS) patients is unknown, estimates vary from 15 to almost 50% of such individuals. The type of neuropathy or myopathy related to the specific stage of HIV infection, the pathogenetic mechanisms involved, and effective therapies are discussed. A neuromuscular disease not only occurs in patients with AIDS and AIDS-related complex, but it can coincide with HIV seroconversion or it can be the only clinical indication of a chronic silent HIV infection. Chronic asymptomatic HIV infection should be considered in the differential diagnosis of certain acquired inflammatory polyneuropathies or myopathies. Precautions needed when doing electromyographic studies are discussed.
Dalakas
M C
MC
National Institute of Neurological and Communicative Disorders and Stroke, Bethesda, MD 20892.
Pezeshkpour
G H
GH
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000473:pathology; D002420:Cauda Equina; D003711:Demyelinating Diseases / Q000150:complications / Q000473:pathology; D003937:Diagnosis, Differential; D005724:Ganglia; D006801:Humans; D009046:Motor Neurons; D009220:Myositis / Q000150:complications / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000175:diagnosis; D009443:Neuritis / Q000150:complications; D009468:Neuromuscular Diseases / Q000145:classification / Q000150:complications* / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D011129:Polyradiculoneuropathy / Q000150:complications / Q000473:pathology