Perry S W
Department of Psychiatry, Cornell University Medical College-The New York Hospital, NY 10021.
Am J Psychiatry. 1990 Jun;147(6):696-710. doi: 10.1176/ajp.147.6.696.
HIV directly affects the CNS, primarily causing subcortical neuropathology. Dementia as the initial presentation is rare, but organic mental changes that mimic many functional disorders can occur during the course of infection. The mental status examination is not adequately sensitive to detect noncognitive dysfunction, and subjective complaints, neurological signs, reduced T4 lymphocytes, CSF abnormalities, diffuse slowing on ECG, mild cerebral atrophy on brain CT, and nonspecific hyperdensities on brain magnetic resonance imaging do not correlate reliably with early and subtle HIV-induced neuropsychological impairment. Zidovudine (AZT) can delay or reverse mental deficits, and psychostimulants can reduce apathetic withdrawal, but high-potency neuroleptics can cause neuroleptic malignant syndrome.
人类免疫缺陷病毒（HIV）直接影响中枢神经系统（CNS），主要引起皮质下神经病理学改变。以痴呆作为首发表现较为罕见，但在感染过程中可出现类似许多功能性障碍的器质性精神改变。精神状态检查对检测非认知功能障碍的敏感性不足，主观症状、神经体征、T4淋巴细胞减少、脑脊液异常、心电图弥漫性减慢、脑CT显示轻度脑萎缩以及脑磁共振成像显示非特异性高密度影，均不能可靠地与早期及细微的HIV诱导的神经心理损害相关联。齐多夫定（AZT）可延缓或逆转精神缺陷，精神兴奋剂可减少淡漠退缩，但高效能抗精神病药物可导致抗精神病药物恶性综合征。
