Léger J M, Bolgert F, Bouche P, Chaunu M P, Hauw J J, Cathala H P, Brunet P
Service de Neurologie, Hôpital de la Salpêtrière, Paris.
Rev Neurol (Paris). 1988;144(12):789-95.
Disorders of the peripheral nervous system occur at all stages of HIV infection. From 13 patients referred for a peripheral neuropathy, 9 were known to be HIV seropositive and 4 were found to be seropositive. All were Caucasian males aged 27 to 58. Ten were homosexual, 2 were drug-addicts. Patients fell into several groups: the first group was made of 5 patients, 4 asymptomatic and 1 AIDS-related-complex (ARC), with an inflammatory demyelinating polyneuropathy, acute in 1 case and subacute in 4; the CSF showed pleiocytosis in all cases. Motor conduction nerve velocities were markedly reduced and motor distal latencies prolonged. Three patients recovered spontaneously, 1 responded to corticosteroids, 1 to plasmapheresis. In the second group, 4 patients, 1 asymptomatic and 3 ARC, had a distal symmetrical polyneuropathy; CSF was normal in 2 cases. Electrophysiological studies and nerve biopsies indicated a mixed axonal-demyelinating polyneuropathy. Three patients recovered spontaneously, 1 is unchanged. Among both groups, an infiltration of mononuclear cells was found on nerve biopsies in 4 cases. The third group was made of 3 patients with AIDS who presented with a painful sensory polyneuropathy involving the distal lower limbs. Electrophysiological and pathological study of the nerve indicated axonal degeneration. No cell infiltration was found. The last patient with AIDS had a progressive meningoradiculopathy. These 4 patients died within 6 months after the onset of the neuropathy. These findings are close to those previously reported, and confirm the wide spectrum of disorders of the peripheral nervous system associated to HIV infection.
外周神经系统疾病在HIV感染的各个阶段均可发生。在13例因周围神经病变前来就诊的患者中，9例已知HIV血清学阳性，4例血清学检查发现为阳性。所有患者均为白种男性，年龄在27至58岁之间。其中10例为同性恋者，2例为吸毒者。患者分为几组：第一组有5例患者，4例无症状，1例为艾滋病相关综合征（ARC），患有炎性脱髓鞘性多发性神经病，1例为急性，4例为亚急性；所有病例脑脊液均显示细胞增多。运动传导神经速度明显降低，运动远端潜伏期延长。3例患者自发恢复，1例对皮质类固醇治疗有反应，1例对血浆置换有反应。第二组有4例患者，1例无症状，3例为ARC，患有远端对称性多发性神经病；2例脑脊液正常。电生理研究和神经活检表明为轴索性与脱髓鞘性混合性多发性神经病。3例患者自发恢复，1例无变化。两组中，4例神经活检发现有单核细胞浸润。第三组有3例艾滋病患者，表现为累及下肢远端的疼痛性感觉性多发性神经病。神经的电生理和病理研究表明为轴突变性。未发现细胞浸润。最后1例艾滋病患者患有进行性脑脊膜神经根病。这4例患者在神经病发作后6个月内死亡。这些发现与先前报道的结果相近，证实了与HIV感染相关的外周神经系统疾病谱广泛。
