What are the neurologic manifestations of early symptomatic HIV infection?

Updated: Jan 02, 2019
  • Author: Robert J Carpenter, DO, AAHIVS, FACP; Chief Editor: John Bartlett, MD  more...
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Answer

Answer

Aseptic meningitis may manifest as headache, photophobia, and frank encephalitis. Cranial nerve involvement may be observed. Cranial nerve VII is affected predominantly; sometimes, nerves V and/or VIII are also affected.

Acute inflammatory demyelinating polyneuropathy causes weakness, areflexia, and minimal sensory changes.

Patients with mononeuritis multiplex develop multifocal asymmetric cranial or peripheral nerve lesions, including facial or laryngeal palsy, wristdrop or footdrop, and other neuropathic symptoms. Early in the course of HIV infection, mononeuritis multiplex is usually limited to a single nerve or a few nerves and resolves spontaneously without treatment.

Myopathy is characterized by proximal muscle weakness as the primary clinical finding.

Encephalopathy or encephalitis can also be seen in acute HIV infection.


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