open access

Vol 48, No 5 (2014)
Case reports
Submitted: 2014-01-28
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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

Anna Jamroz-Wiśniewska1, Jacek Jaworski1, Dorota Suszek2, Marzena Janczarek3, Zbigniew Stelmasiak1, Konrad Rejdak1, Halina Bartosik-Psujek1
DOI: 10.1016/j.pjnns.2014.09.004
·
Neurol Neurochir Pol 2014;48(5):378-381.
Affiliations
  1. Department of Neurology, Lublin Medical University, Lublin, Poland
  2. Department of Rheumatology, Lublin Medical University, Lublin, Poland
  3. Department of Interventional Radiology and Neuroradiology, Lublin Medical University, Lublin, Poland

open access

Vol 48, No 5 (2014)
Case reports
Submitted: 2014-01-28

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.

Get Citation

Keywords

HIV, Spastic paraparesis, PML

About this article
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

Vol 48, No 5 (2014)

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

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