Neurological Manifestations of AIDS

What is 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 impairing their proper function. HIV infection may cause damage to the brain and spinal cord, causing encephalitis (inflammation of the brain), meningitis (inflammation of the membranes surrounding the brain), nerve damage, difficulties in thinking (i.e., AIDS dementia complex), behavioral changes, poor circulation, headache, and 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, but may become severe in the final stages. Complications vary widely from one patient to another. Cerebral toxoplasmosis, a common OI in AIDS patients, causes such symptoms as headache, confusion, lethargy, and low-grade fever. Other symptoms may include weakness, speech disturbance, ataxia, apraxia, seizures, and sensory loss. Progressive multifocal leukoencephalopathy (PML), a disorder that can also occur in AIDS patients, causes weakness, hemiparesis or facial weakness, dysphasia, vision loss, and ataxia. Some patients with PML may also develop compromised memory and cognition.

Is there any treatment?

There is no cure for AIDS but recently developed, experimental treatments appear very promising. Some symptoms and complications may improve with treatment. For example, antidementia drugs may relieve confusion and slow mental decline. Infections may be treated with antibiotics. 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 underrecognized by AIDS clinicians, so patients who suspect they are having neurological complications should be sure to discuss these with their doctor.

What is the prognosis?

The prognosis for individuals with AIDS in recent years has improved significantly because of new drugs and treatments, and educational and preventive efforts.

What research is being done?

The NINDS supports a broad spectrum of basic and clinical research studies on the neurological complications of AIDS. Much of this research is conducted at leading biomedical research institutions across the country.

Selected references

McArthur J.
Neurologic Manifestations of Human Immunodeficiency Virus Infection. In Diseases of the Central Nervous System: Clinical Neurobiology, W.B. Saunders Co., Philadelphia, pp. 1312-1330 (1992).

Mintz M., and Epstein, L.
Neurologic Manifestations of Pediatric Acquired Immunodeficiency Syndrome: Clinical Features and Therapeutic Approaches. Seminars in Neurology, 12:1; 51-56 (March 1992)

Newton, H
Common Neurologic Complications of HIV-1 Infection and AIDS. American Family Physician, 51:2; 387-398 (February 1, 1995).

Pajeau, A, and Roman, G.
HIV Encephalopathy and Dementia. Psychiatric Clinics of North America, 15:2; 455-466 (June 1992).

Simpson, D, and Tagliati, M
Neurologic Manifestations of HIV Infection. Annals of Internal Medicine, 121:10; 769-785 (November 1994)

Source: National Institute of Neurological Disorders and Stroke, National Institutes of Health