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Revista Cubana de Medicina

versión impresa ISSN 0034-7523versión On-line ISSN 1561-302X


CASANOVA SOTOLONGO, Pedro; CASANOVA CARRILLO, Pedro  y  CASANOVA CARRILLO, Carlos. Enfermedades de la médula espinal en el curso de la infección por el virus de la inmunodeficiencia humana. Rev cubana med [online]. 2003, vol.42, n.6. ISSN 0034-7523.

On making a review of the neurological complications in AIDS patients, it was proved that they are diverse, frequent and include opportunistic infections and lymphomas, as well as peripheral neuropathy, myelopathy and dementia related to the acquired immunodeficiency virus (HIV). The spinal cord lesions generally appear at a late stage of the disease and on some occassions they are not noticed by physicians, who are not accostumed to see them. Their appareance as a first sign of the disease is very rare. The most common spinal cord affections in these cases are vacuolar myelopahty and myelitis. A close pathological similarity between AIDS-related myelopathies and the vacuolar myelopathy has been stressed based on the findings on vitamin B12 deficiency that suggest that an abnormality in the metabolism of this vitamin dependent of the transmethylation pathway may be important in the myelopathy genesis in AIDS. Taking into account the possible association between the HIV-1 viral burden in the cerebrospinal fluid and the cognitive disorders, there have been advances in the hypothesis about a similar mechanism with myelopathy, but it has not been possible to establish a correlation of this entity with the viral burden The diagnosis is based on the clinical picture of the spinal cord lesion, mainly on motor disorders with pyramidal signs and sphincteral dysfucntion.A high incidence of paraparesis, paresthesias, spasticity and backache has been stressed. The genesis of myelopathy in this entity is really unknown. The benefits of prophylaxis and of antiretroviral therapy have changed the focus of attention of the neurological diseases in the course of AIDS.


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