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: Anna Jamroz-Wiśniewska, Jacek Jaworski, Dorota Suszek, Marzena Janczarek, Zbigniew Stelmasiak, Konrad Rejdak, Halina Bartosik-Psujek
• Journal: Neurologia i neurochirurgia polska (Neurol Neurochir Pol) Vol. 48 Issue 5 Pg. 378-81 ( 2014) ISSN: 0028-3843 [Print] Poland
• PMID: 25440019 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Chemical References

• Anti-Retroviral Agents

Topics

• Adult
• Anti-Retroviral Agents (therapeutic use)
• Female
• HIV Infections (complications, drug therapy)
• Humans
• Leukoencephalopathies (drug therapy, etiology)
• Magnetic Resonance Imaging
• Paraparesis, Spastic (drug therapy, etiology, virology)
• Recovery of Function (drug effects)