Rabhi Samira, Amrani Kawthar, Maaroufi Mustapha, Khammar Zineb, Khibri Hajar, Ouazzani Maha, Berrady Rhizlane, Tizniti Siham, Messouak Ouafae, Belahsen Faouzy, Bono Wafaa
Department of Internal medicine, Hassan II University Hospital, Faculty of Medicine and Pharmacy, University Sidi Mohammed Ben Abdellah, Morocco.
Pan Afr Med J. 2011;10:9. doi: 10.4314/pamj.v10i0.72216. Epub 2011 Sep 25.
Neurologic signs and symptoms may represent the initial presentation of AIDS in 10-30% of patients. Movement disorders may be the result of direct central nervous system infection by human immunodeficiency virus (HIV) or the result of opportunistic infections. We report the case of a 59 years old woman who had hemichorea-hemiballismus subsequently found to be secondary to a cerebral toxoplasmosis infection revealing HIV infection. Movement disorders, headache and nausea were resolved after two weeks of antitoxoplasmic treatment. Brain MRI control showed a marked resolution of cerebral lesion. Occurrence of hemichorea-ballismus in patient without familial history of movement disorders suggests a diagnosis of AIDS and in particular the diagnosis of secondary cerebral toxoplasmosis. Early recognition is important since it is a treatable entity.
神经系统症状和体征可能是10%至30%的艾滋病患者的首发表现。运动障碍可能是人类免疫缺陷病毒(HIV)直接感染中枢神经系统的结果,也可能是机会性感染的结果。我们报告了一例59岁女性患者,其出现偏侧舞蹈症-偏侧投掷症,随后发现继发于脑弓形虫感染,进而揭示了HIV感染。经过两周的抗弓形虫治疗后,运动障碍、头痛和恶心症状得到缓解。脑部MRI检查显示脑部病变明显消退。在没有运动障碍家族史的患者中出现偏侧舞蹈症-偏侧投掷症提示艾滋病的诊断,尤其是继发性脑弓形虫病的诊断。早期识别很重要,因为这是一个可治疗的疾病。