Neurological Manifestations of AIDS

Acquired immune deficiency syndrome (AIDS) is the result of an infection with the human immunodeficiency virus (HIV). This virus attacks selected cells of the immune, nervous, and other systems. It impairs their proper function. HIV infection may cause damage to the brain and spinal cord. This may cause:

  • Inflammation of the brain (encephalitis).

  • Inflammation of the membranes around the brain (meningitis).

  • Nerve damage.

  • Difficulty in thinking (i.e., AIDS dementia complex).

  • Behavioral changes.

  • Poor circulation.

  • Headache.

  • Stroke.

AIDS-related cancers (such as lymphoma) and opportunistic infections (OI) may also affect the nervous system. Neurological symptoms may be mild in the early stages of AIDS. However, they may become severe in the final stages. Complications vary from one patient to another.

  • Cerebral toxoplasmosis is a common OI in patients with AIDS. It may cause:

  • Headache.

  • Confusion.

  • Lethargy.

  • Low-grade fever.

  • Weakness.

  • Speech disturbance.

  • Ataxia.

  • Apraxia.

  • Seizures.

  • Sensory loss.

  • Progressive multifocal leukoencephalopathy (PML) can also happen in patients with AIDS. It may cause:

  • Weakness.

  • Facial weakness (hemiparesis).

  • Dysphasia.

  • Vision loss.

  • Ataxia.

  • Some patients may also develop compromised memory and cognition.

TREATMENT

There is no cure for AIDS. Some symptoms and complications may improve with treatment. For example, anti-dementia drugs may relieve confusion and slow mental decline. Infections may be treated with antibiotic medicines. Radiation therapy may be needed to treat AIDS-related cancers present in the brain or spinal cord. Drug "cocktails" recommended to treat AIDS can cause neuropathy. Neurological complications of AIDS are often under recognized by AIDS clinicians. So patients who suspect they are having neurological complications should be sure to discuss these with their caregivers.