Brainstem toxoplasmosis in patients with acquired immunodeficiency syndrome.
Brainstem involvement by Toxoplasma gondii is probably more common than other opportunistic infections, although it has not received adequate attention. Identification of toxoplasmosis is essential, as this condition responds to treatment with a significant increase in life expectancy. During the past 4 years, 366 AIDS patients with central nervous system toxoplasmosis diagnosed by biopsy or improvement following empirical treatment were evaluated. Among them, 8 (7 men, 1 woman; aged 25-55 yr) presented with signs of brainstem dysfunction. Six patients presented with an oculomotor nerve palsy and contralateral hemiplegia; 1 had an additional ipsilateral rubral tremor. The seventh patient had complete external ophthalmoplegia and the eighth had Parinaud's syndrome. Computed tomography revealed enhancing lesions in the brainstem of all patients. Seven responded to treatment with pyrimethamine and sulfadiazine.
Daras
M
M
Department of Neurology, Metropolitan Hospital, New York Medical College, NY 10029.
Koppel
B S
BS
Samkoff
L
L
Marc
J
J
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D001933:Brain Stem / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000000981:diagnostic imaging; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016781:Toxoplasmosis, Cerebral / Q000000981:diagnostic imaging*