title: Ascending paralysis associated with HIV infection.
abstract: We present two patients with a high viral load of HIV-1 who developed symptoms of ascending paralysis leading to respiratory failure and autonomic instability. One patient had symptom improvement with highly active antiretroviral therapy (HAART) and a subsequent decrease in viral load. The other patient improved with intravenous immunoglobulin therapy and did not show much improvement on HAART alone. There are several proposed mechanisms for peripheral neuropathies seen in HIV-infected patients, including a direct action of HIV on the nerve by neurotropic strains or formation of autoantibodies against nerve elements. The comparison of the response to different therapies in these two cases highlights the importance of understanding different pathophysiologies, as the treatment modality may differ.
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Aasim
authors.initials: A
authors.lastname: Afzal
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Mina
authors.initials: M
authors.lastname: Benjamin
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Kyle L
authors.initials: KL
authors.lastname: Gummelt
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Afzal
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Sadat
authors.initials: S
authors.lastname: Shamim
authors.affiliation: Department of Internal Medicine (Afzal, Benjamin, Gummelt), the Division of Neurology (Shamim), and the Division of Infectious Diseases (Tribble), Baylor University Medical Center at Dallas.
authors.forename: Marc
authors.initials: M
authors.lastname: Tribble