[Visual and central oculomotor disorders in patients with acquired immunodeficiency syndrome].
A clinical evaluation of visual and central oculomotor defects are presented in a series of 56 patients who were HIV carriers, of whom 47 fulfilled criteria for AIDS. Changes were detected in 22% of the asymptomatic patients (2/9), in 36% of the AIDS patients with no neurological complications and in 93% (15/16) of the AIDS patients with neurological involvement. Some changes were seen in 55% of the patients with AIDS. The commonest defects were alterations of saccadic movements and visual pursuit (35% respectively) and of opticokinetic nystagmus (28%). Only one homonymous visual defect was found. No brain stem syndromes were seen, except for one case of bilateral internuclear ophthalmoplegia. The commonest neurological complications were toxoplasmosis, the AIDS dementia complex (ADC) and multifocal leukoencephalopathy (MLP). Neuro-ophthalmological changes are described, in the literature, in 2-12%. Central oculomotor disorders, including supranuclear, nuclear and internuclear ophthalmoplegias are frequent and probably underestimated. Nystagmus is a common sign and there are isolated descriptions of flutter, opsoclonus and ocular dipping. The causes of visual and oculomotor changes reflect the incidence of parenchymatous neurological complications of AIDS. MLP is the commonest cause of change in the retrogeniculate optic pathways. Oculographic studies show changes in saccadic movements and ocular pursuit and signs of unstable visual fixation. These changes are seen in all ADC patients, in a large proportion of those without dementia and also in asymptomatic carriers, suggesting that oculography may be useful for prognosis.
Roig
C
C
Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Medicina, Barcelona, España.
Iranzo
A
A
D015526:AIDS Dementia Complex / Q000150:complications; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000503:physiopathology; D000328:Adult; D001921:Brain / Q000503:physiopathology; D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000150:complications; D011446:Prospective Studies; D014123:Toxoplasmosis / Q000150:complications; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis
Trastornos visuales y oculomotores centrales en pacientes con síndrome de inmunodeficiencia adquirida (SIDA).