Navia B A, Jordan B D, Price R W
Ann Neurol. 1986 Jun;19(6):517-24. doi: 10.1002/ana.410190602.
Of 70 autopsied patients with the acquired immune deficiency syndrome (AIDS), 46 suffered progressive dementia that was frequently accompanied by motor and behavioral dysfunction. Impaired memory and concentration with psychomotor slowing represented the most common early presentation of this disorder, but in nearly one half of the patients either motor or behavioral changes predominated. Early motor deficits commonly included ataxia, leg weakness, tremor, and loss of fine-motor coordination, while behavioral disturbances were manifested most commonly as apathy or withdrawal, but occasionally as a frank organic psychosis. The course of the disease was steadily progressive in most patients, and at times was punctuated by an abrupt acceleration. However, in 20% of patients a more protracted indolent course was observed. In the most advanced stage of this disease, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus. The high incidence and unique clinical presentation of this AIDS dementia complex is consistent with the emerging concept that this complication is due to direct brain infection by the retrovirus that causes AIDS.
在70例接受尸检的获得性免疫缺陷综合征（AIDS）患者中，46例患有进行性痴呆，常伴有运动和行为功能障碍。记忆受损、注意力不集中以及精神运动迟缓是该疾病最常见的早期表现，但近一半患者以运动或行为改变为主。早期运动缺陷通常包括共济失调、腿部无力、震颤以及精细运动协调能力丧失，而行为障碍最常见的表现为冷漠或退缩，但偶尔也会出现明显的器质性精神病。大多数患者的疾病进程呈稳步进展，有时会突然加速。然而，20%的患者病程较为迁延缓慢。在该疾病的最晚期，患者表现出严重痴呆、缄默、大小便失禁、截瘫的典型症状，在某些情况下还会出现肌阵挛。这种AIDS痴呆综合征的高发病率和独特临床表现与一种新出现的观点一致，即这种并发症是由导致AIDS的逆转录病毒直接感染大脑所致。
