title: Cerebellar Dysfunction in a Patient with HIV.
abstract: A 50-year-old AIDS patient with a CD4 T-cell count of 114/mm(3) was admitted with cerebellar symptoms of left CN XI weakness, wide-based gait with left-sided dysmetria, abnormal heel-knee-shin test, and dysdiadochokinesia. MRI showed region of hyperintensity in the left inferior cerebellar hemisphere involving the cortex and underlying white matter. Serological tests for HSV1, HSV2, and syphilis were negative. Her CSF contained high protein content and a WBC of 71/mm(3), predominantly lymphocytes. The CSF was also negative for cryptococcal antigen and VDRL. CSF culture did not grow microbes. CSF PCR assay was negative for HSV1 and HSV2 but was positive for JC virus (1,276 copies). The most likely diagnosis is granule cell neuronopathy (GCN), which can only be definitively confirmed with biopsy and immunohistochemistry.
authors.affiliation: Department of Internal Medicine, Jersey City Medical Center, Mount Sinai School of Medicine, 355 Grand Street, Jersey City, NJ 07302, USA.
authors.forename: Fernando
authors.identifier: 0000-0001-9136-1108
authors.initials: F
authors.lastname: Gonzalez-Ibarra
authors.affiliation: Department of Internal Medicine, Jersey City Medical Center, St. George's University School of Medicine, NJ 07302, USA.
authors.forename: Waheed
authors.initials: W
authors.lastname: Abdul
authors.affiliation: Department of Internal Medicine, Jersey City Medical Center, Mount Sinai School of Medicine, 355 Grand Street, Jersey City, NJ 07302, USA.
authors.forename: Sahar
authors.initials: S
authors.lastname: Eivaz-Mohammadi
authors.affiliation: Department of Internal Medicine, Jersey City Medical Center, St. George's University School of Medicine, NJ 07302, USA.
authors.forename: Christopher
authors.identifier: 0000-0001-5387-7074
authors.initials: C
authors.lastname: Foscue
authors.affiliation: Department of Internal Medicine, Jersey City Medical Center, Mount Sinai School of Medicine, 355 Grand Street, Jersey City, NJ 07302, USA.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Gongireddy
authors.affiliation: Laureate National Institute of Medicine, Program Director Internal Medicine, Jersey City Medical Center, 355 Grand Street, Jersey City, NJ 07302, USA.
authors.forename: Amer
authors.initials: A
authors.lastname: Syed
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