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Disappearance of white matter lesions on MRI and clinical recovery after initiating antiretroviral therapy in a case of HIV infection presenting as spastic paraparesis
- Department of Neurology, Lublin Medical University, Lublin, Poland
- Department of Rheumatology, Lublin Medical University, Lublin, Poland
- Department of Interventional Radiology and Neuroradiology, Lublin Medical University, Lublin, Poland
open access
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.
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.
Keywords
HIV, Spastic paraparesis, PML
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
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
378-381
Page views
492
Article views/downloads
578
DOI
10.1016/j.pjnns.2014.09.004
Bibliographic record
Neurol Neurochir Pol 2014;48(5):378-381.
Keywords
HIV
Spastic paraparesis
PML
Authors
Anna Jamroz-Wiśniewska
Jacek Jaworski
Dorota Suszek
Marzena Janczarek
Zbigniew Stelmasiak
Konrad Rejdak
Halina Bartosik-Psujek