How is HIV-associated vacuolar myelopathy (VM) treated?

Updated: May 07, 2018
  • Author: Krupa Pandey, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Care for patients with HIV-associated vacuolar myelopathy (VM) is primarily supportive. Although no specific treatment is currently approved for this syndrome, viral control tailored to the individual patient's medical and viral history is important, as clinical and radiologic improvement with highly active retroviral therapy (HAART) have been described. [12, 13, 14, 5]

A pilot study showed improvement in patients treated with L-methionine. [15] However, a randomized, double-blind, placebo-controlled study of 56 patients showed no benefit. [16]  

Symptomatic management relies on antispasmodics such as baclofen or tizanidine and intramuscular botulinum toxin to manage spasticity, pain management, and anticholinergic drugs to improve bladder function. [17]

Refer the patient to a physical medicine specialist for spinal cord treatment and follow-up care.

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