Gastaut J L, Gastaut J A, Pellissier J F, Tapko J B, Weill O
Service de Neurologie, Hôpital Sainte-Marguerite, Marseille.
Rev Neurol (Paris). 1989;145(6-7):451-9.
Neurologic disorders are common in patients infected with HIV1. Judging from reported cases, the central nervous system would be more frequently involved than the peripheral nervous system (PNS). The purpose of the present prospective study was to ascertain the incidence and the nature of PNS disorders in patients infected with HIV1. Fifty-six patients [asymptomatic carriers: 5; persistent generalized lymphadenopathy (PGL): 13; AIDS related complex (ARC): 9 and acquired immunodeficiency syndrome (AIDS): 29] were submitted to clinical and laboratory investigations and 52 underwent electromyogram and nerve conduction velocity tests. CSF was examined in 29 and nerve biopsies in 28. Our findings showed that a PNS impairment was present in 50/56 patients i.e. 89 p. 100. It was mainly a moderate sensory polyneuropathy, more often at the subclinical (29/50: 58 p. 100) than at the clinical (21/50: 42 p. 100) level. It concerned asymptomatic carriers (2/5) as well as PGL (11/13), ARC (8/9) and AIDS (29/29) patients. These data show that peripheral nerves are a target for HIV1.
神经系统疾病在感染HIV1的患者中很常见。从报告的病例来看,中枢神经系统比周围神经系统(PNS)更常受累。本前瞻性研究的目的是确定感染HIV1患者中PNS疾病的发病率和性质。56例患者[无症状携带者:5例;持续性全身性淋巴结病(PGL):13例;艾滋病相关综合征(ARC):9例;获得性免疫缺陷综合征(AIDS):29例]接受了临床和实验室检查,52例进行了肌电图和神经传导速度测试。29例检查了脑脊液,28例进行了神经活检。我们的研究结果表明,56例患者中有50例(即89%)存在PNS损伤。主要是中度感觉性多发性神经病,亚临床水平(29/50:58%)比临床水平(21/50:42%)更常见。它涉及无症状携带者(2/5)以及PGL患者(11/13)、ARC患者(8/9)和AIDS患者(29/29)。这些数据表明周围神经是HIV1的攻击目标。