title: Disappearance of white matter lesions on MRI and clinical recovery after initiating antiretroviral therapy in a case of HIV infection presenting as spastic paraparesis.
abstract: We present a case of a 30-year-old Polish female who presented with increasing for about 2 years spastic paraparesis and urinary incontinence. She denied any risky sexual behaviors, drug abuse, there was no history of surgery or blood transfusions. MRI of the brain showed diffuse, hyperintensive in T2, poorly defined lesions in the white matter. About 3 months later paraparesis increased and control MRI showed progression of previously described lesions. She was then diagnosed with HIV infection. There was a suspicion of progressive multifocal leucoencephalopathy (PML) or vacuolar myelopathy in the course of HIV infection. Antiretroviral treatment was initiated leading, together with rehabilitation, to a progressive improvement of symptoms. Pathological lesions on brain MRI completely disappeared. In conclusion, HIV test should be done in every patient with neurological signs of unknown cause.
authors.affiliation: Department of Neurology, Lublin Medical University, Lublin, Poland. Electronic address: anna.jamroz@umlub.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Jamroz-Wiśniewska
authors.affiliation: Department of Neurology, Lublin Medical University, Lublin, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Jaworski
authors.affiliation: Department of Rheumatology, Lublin Medical University, Lublin, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Suszek
authors.affiliation: Department of Interventional Radiology and Neuroradiology, Lublin Medical University, Lublin, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Janczarek
authors.affiliation: Department of Neurology, Lublin Medical University, Lublin, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Stelmasiak
authors.affiliation: Department of Neurology, Lublin Medical University, Lublin, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Rejdak
authors.affiliation: Department of Neurology, Lublin Medical University, Lublin, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Bartosik-Psujek
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D056784:Leukoencephalopathies / Q000188:drug therapy* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D020336:Paraparesis, Spastic / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D020127:Recovery of Function / Q000187:drug effects*
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; PML; Spastic paraparesis