How are neurologic abnormalities diagnosed in 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

A lumbar puncture is an important element of the evaluation in patients with HIV infection who have neurologic abnormalities. A lumbar puncture is most helpful in the diagnosis of opportunistic infections. In aseptic meningitis or encephalitis, cerebrospinal fluid (CSF) examination reveals lymphocytic pleocytosis, an elevated protein level, and a normal glucose level.

In acute inflammatory demyelinating polyneuropathy, CSF examination reveals pleocytosis and increased protein levels. A peripheral nerve biopsy reveals a perivascular infiltrate, suggesting an autoimmune etiology. Electromyography (EMG) reveals demyelination.


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