Kollegger H, Sagmeister T, Deecke L
Neurologische Universitätsklinik Wien.
Med Klin (Munich). 1992 Sep 15;87(9):449-53.
This retrospective investigation of neurological deficits in 95 consecutive patients (77 men, mean age 35 years; 18 women, mean age 28 years) infected by the human immunodeficiency virus showed that 61% of the female and 47% of the male patients exhibited neurological deficits. In 18% of the total population neurological deficits were the initial sign of acquired immunodeficiency. In addition, we found that a history of headaches and the clinical finding of mental impairment as well as internistic symptoms were significantly correlated with neurological deficits. Patients suffering from cerebral toxoplasmosis developed mental impairment significantly more often than patients with central nervous symptoms of other etiogenesis. Furthermore, it was found that HIV-infected women manifested peripheral neuropathies more often than HIV-infected men. The overall mortality rate over the investigation period of 30 months was 28%. The results of our retrospective investigation indicate that HIV-infected patients have a high risk of developing lesions of the central and peripheral nervous system during the course of the disease. Various reasons might be responsible for these findings: neurotropy and metamorphosis of the human immunodeficiency virus, opportunistic infections and tumors, vitamin deficiencies, and a variety of diseases prior to HIV-infection.
对95例连续感染人类免疫缺陷病毒的患者(77名男性,平均年龄35岁;18名女性,平均年龄28岁)进行的神经系统缺陷回顾性调查显示,61%的女性患者和47%的男性患者存在神经系统缺陷。在全部患者中,18%的患者神经系统缺陷是获得性免疫缺陷的初始症状。此外,我们发现头痛病史、精神障碍的临床发现以及内科症状与神经系统缺陷显著相关。患有脑弓形虫病的患者比其他病因引起中枢神经症状的患者更常出现精神障碍。此外,还发现感染HIV的女性比感染HIV的男性更常出现周围神经病变。在30个月的调查期内,总死亡率为28%。我们回顾性调查的结果表明,感染HIV的患者在疾病过程中发生中枢和周围神经系统病变的风险很高。这些发现可能有多种原因:人类免疫缺陷病毒的嗜神经性和变性、机会性感染和肿瘤、维生素缺乏以及HIV感染前的各种疾病。