G Mariam Ayle, Assefa Getachew
Bole Clinic, Addis Ababa, Ethiopia.
Ethiop Med J. 2012 Oct;50(4):337-47.
Neurological dysfunction in AIDS is common, occurring in as many as eighty percent of children. Thus, it is important to recognize the central nervous system imaging appearance of HIV, in particular those of HIV encephalopathy, as this is an AIDS defining illness and with distinct neuro-imaging features essential for early diagnosis and timely therapeutic intervention
To identify the clinical features in HIV-1 infection of the central nervous system and their associated neuroradiological correlates.
Retrospective review of the records of all children with HIV-1 encephalopathy identified among children with neurological and developmental problems and who were on follow up at a child development and neurology clinic in an African city.
A total of 22 children (10 male and 12 female) with HIV-1 encephalopathy were identified among 2382 children with various forms of neurological and developmental problems and who were on follow up at a child development and neurology clinic for a little bit over eight years period. All the children acquired the infection vertically. The age range of these children was between 10 months to 14 years. The median age was 5.6 years. The mean duration of symptom was 3.2 years. Global delay or regression in development along with signs of pyramidal tract involvement and seizures were the commonest clinical signs observed in these children. Neuro-behavioral problems were commonly observed among preschool and school aged children. In older children and preadolescents focal seizures with or with out neurologic deficit and neuroradiological findings were common. Nonhemorrhagic stroke was rare and occurred in one child and another child had cortical blindness. Three children had no neurological deficit. Rapid progression of the disease carried grave prognosis. Opportunistic infections and tumors of the central nervous system were also uncommon among these children. Brain volume loss with dilatation of the lateral ventricle, bilateral symmetrical or asymmetrical calcification of the basal ganglia and periventricular involvement of the white matter were the commonest neuro-radiological findings observed in these children.
Atrophy of the brain with dilatation of the lateral ventricles and calcification of the basal ganglia and peri-ventricular involvement of the white matter were the commonest neuro-radiological findings in children with HIV-1 encephalopathy. Similarly global delay or regression in development along with pyramidal tract signs and seizures were the commonest neurological findings. Behavioral problems were common in preschool and school aged children. Focal seizures were common in older children and preadolescents. Rapid progression of the disease carried grave prognosis.
艾滋病中的神经功能障碍很常见，多达80%的儿童会出现这种情况。因此，认识人类免疫缺陷病毒（HIV）的中枢神经系统影像学表现很重要，尤其是HIV脑病的表现，因为这是一种定义艾滋病的疾病，具有独特的神经影像学特征，对早期诊断和及时的治疗干预至关重要。
确定HIV-1感染中枢神经系统的临床特征及其相关的神经放射学关联。
回顾性分析在非洲某城市一家儿童发育与神经科诊所随访的、患有神经和发育问题的儿童中确诊为HIV-1脑病的所有儿童的记录。
在2382名患有各种形式神经和发育问题且在一家儿童发育与神经科诊所随访了8年多的儿童中，共确诊了22例HIV-1脑病患儿（10名男性和12名女性）。所有儿童均为垂直感染。这些儿童的年龄在10个月至14岁之间。中位年龄为5.6岁。症状的平均持续时间为3.2年。发育全面延迟或倒退以及锥体束受累和癫痫发作的体征是这些儿童中最常见的临床体征。在学龄前和学龄儿童中普遍观察到神经行为问题。在大龄儿童和青春期前儿童中，伴有或不伴有神经功能缺损及神经放射学表现的局灶性癫痫发作很常见。非出血性中风很少见，有1名儿童发生，另1名儿童有皮质盲。3名儿童没有神经功能缺损。疾病快速进展预后严重。这些儿童中中枢神经系统的机会性感染和肿瘤也不常见。脑容量减少伴侧脑室扩张、基底节双侧对称或不对称钙化以及白质脑室周围受累是这些儿童中最常见的神经放射学表现。
脑萎缩伴侧脑室扩张、基底节钙化以及白质脑室周围受累是HIV-1脑病患儿最常见的神经放射学表现。同样，发育全面延迟或倒退以及锥体束体征和癫痫发作是最常见的神经学表现。行为问题在学龄前和学龄儿童中很常见。局灶性癫痫发作在大龄儿童和青春期前儿童中很常见。疾病快速进展预后严重。
