Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-26T14:10:39.263Z Has data issue: false hasContentIssue false

Sensorimotor Neuropathy and Abnormal Vitamin B12 Metabolism in Early HIV Infection

Published online by Cambridge University Press:  18 September 2015

M. Veilleux*
Affiliation:
Division of Neurology, Montreal General Hospital and McGill University, Montreal
O. Paltiel
Affiliation:
Division of Haematology, Montreal General Hospital and McGill University, Montreal
J. Falutz
Affiliation:
Immunodeficiency Treatment Center, Montreal General Hospital and McGill University, Montreal
*
Division of Neurology, Room L7-408, Montreal Genera] Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Distal sensory peripheral neuropathy (DSPN) has been reported in 5 to 75% of patients with human immunodeficiency virus (HIV) infection, particularly in advanced stages of the disease. Twenty HIV seropositive patients were studied prospectively to determine the frequency of DSPN in clinical stage II and III of the HIV infection, and to investigate the role of vitamin B12 deficiency on the frequency of DSPN in HIV patients. All patients had complete blood count, serum vitamin B12 level, anti-intrinsic factor antibody, Schilling test, and electrodiagnostic studies including nerve conduction studies and concentric needle examination in the lower extremities, and sympathetic skin responses. Only 1 patient (5%) had clinical and electrophysiological evidence of possible DSPN. Of the 6 patients with abnormal Schilling test, only one had DSPN based on distal sensory symptoms, abnormal neurological examination and electrodiagnostic studies. Evidence for possible DSPN was present in 5% of patients with early HIV infection and did not appear to be more frequent in patients with concurrent vitamin B12 deficiency.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

References

1. Gastaut, JL, Gastaut, JA, Pelissier, JF, et al. Neuropathies périphériques qu cours de l’infection par le virus de l’immuno-déficience humaine. Rev Neurol 1989; 145: 451459.Google Scholar
2. Jakobsen, J, Smith, T, Gaub, J, et al. Progressive neurological dysfunction during latent HIV infection. Br Med J 1989; 299: 225228.CrossRefGoogle ScholarPubMed
3. Janssen, RS, Saykin, AJ, Kaplan, JE, et al. Neurologic complications of lymphadenopathy syndrome associated with human immunodeficiency virus infection. Neurology 1987; 37 (Suppl.): 344.Google Scholar
4. Janssen, RS, Saykin, AJ, Kaplan, JE, et al. Neurological symptoms and neuropsychological abnormalities in lymphadenopathy syndrome. Ann Neurol 1988; 23 (Suppl.) S17-S18.CrossRefGoogle ScholarPubMed
5. Lange, DJ.AAEM Minimonograph #41: Neuromuscular diseases associated with HIV-1 infection. Muscle Nerve 1994; 17: 1630.CrossRefGoogle Scholar
6. Leger, JM, Bouche, P, Bolgert, F, et al. The spectrum of polyneuropathies in patients infected with HIV. J Neurol Neurosurg Psychiatry 1989; 52: 13691374.CrossRefGoogle ScholarPubMed
7. Levy, RM, Bredesen, DE, Rosenblum, ML.Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg 1985; 38: 794796.Google Scholar
8. McArthur, JC, Cohen, BA, Seines, OA, et al. Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1-infected individuals: results from the Multicenter AIDS Cohort Study. Ann Neurol 1989; 26: 601611.CrossRefGoogle ScholarPubMed
9. Parry, GJ.Peripheral neuropathies associated with human immunodeficiency virus infection. Ann Neurol 1988; 23 (Suppl.): S49S53.CrossRefGoogle ScholarPubMed
10. Smith, T, Jakobsen, J, Gaub, J, Trojaborg, W.Symptomatic polyneuropathy in human immunodeficiency virus antibody seropositive men with and without immune deficiency: a comparative electrophysiological study. J Neurol Neurosurg Psychiatry 1990; 53: 10561059.CrossRefGoogle ScholarPubMed
11. Snider, WD, Simpson, DM, Nielsen, S, et al. Neurologic complications of acquired immunodeficiency syndrome: analysis of 50 patients. Ann Neurol 1983; 14: 403418.CrossRefGoogle ScholarPubMed
12. So, YT, Holtzman, DM, Abrams, DI, Olney, RK.Peripheral neuropathy associated with acquired immunodeficiency syndrome. Prevalence and clinical features from a population-based survey. Arch Neurol 1988; 45: 945948.CrossRefGoogle ScholarPubMed
13. Kieburtz, KD, Giang, DW, Schiffer, RB, Vakil, N.Abnormal vitamin B|2 metabolism in human immunodeficiency virus infection; association with neurological dysfunction. Arch Neurol 1991; 48: 312314.CrossRefGoogle ScholarPubMed
14. Centres For Diseases Control. Classification system for human T-lymphotropic virus type III/lymphadenopathy associated with virus infections. MMWR 1986; 35 (20): 334338.Google Scholar
15. Janssen, RS, Cornblath, DR, Epstein, LY, and Task, Force.Nomenclature and research case definitions of neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection: report of a working group of the American Academy of Neurology AIDS Task Force. Neurology 1991; 41:778785.Google Scholar
16. Daube, JR.Nerve conduction studies. In: Aminoff, MJ, ed. Electrodiagnosis in Clinical Neurology. New York: Churchill-Livingstone 1986; 265306.Google Scholar
17. Shahani, BG, Halperin, JJ, Boulu, PJ, Cohen, J.Sympathetic skin response – a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 1984; 47: 536542.CrossRefGoogle ScholarPubMed
18. Dalakas, MC.Neuromuscular complications of AIDS. Muscle Nerve 1986; 9: 92.Google Scholar
19. Dalakas, MC, Pezeshkpour, GH.Neuromuscular diseases associated with human immunodeficiency virus infection. Ann Neurol 1988; 23 (Suppl.): S38S48.CrossRefGoogle ScholarPubMed
20. Simpson, DA.Neuromuscular complications of human immunodeficiency virus infection. Semin Neurol 1992; 12(1): 3442.CrossRefGoogle ScholarPubMed
21. Janssen, RS, Saykin, AJ, Cannon, L, et al. Neurological and neuropsychological manifestations of HIV-1 infection: association with AIDS-related complex but not asymptomatic HIV-1 infection. Ann Neurol 1989; 26: 592600.CrossRefGoogle Scholar
22. McAllister, RH, Herns, MV, Harrison, MJG, et al. Neurological and neuropsychological performance in HIV seropositive men without symptoms. J Neurol Neurosurg Psychiatry 1992; 55: 143148.CrossRefGoogle ScholarPubMed
23. Trimble, KC, Goggins, MG, Molloy, AM, et al. Vitamin B12 deficiency is not a cause of HIV-associated neuropathy. AIDS 1993; 7(8): 11321133.CrossRefGoogle Scholar
24. Harriman, GR, Smith, PD, HOrne, MK, et al. Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome. Arch Intern Med 1989; 149: 20392041.CrossRefGoogle ScholarPubMed