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Neurologic Syndromes

Anita Lesgold Belman, MD; Gary Diamond, MD; Dennis Dickson, MD; Dikran Horoupian, MD; Josefina Llena, MD; George Lantos, MD; Arye Rubinstein, MD

Am J Dis Child. 1988;142(1):29-35.

Abstract
• Central nervous system (CNS) dysfunction was documented in 61 of 68 infants and children with symptomatic human immunodeficiency virus infection. The most frequent manifestations included acquired microcephaly, cognitive deficits, and bilateral pyramidal tract signs. Lymphoma of the CNS, cerebrovascular accidents, and CNS infection caused by conventional pathogens were documented in only ten children (15%). Neurologic deterioration in 11 children was subacute but steadily progressive; in 31 the course was more indolent and began with a plateau. Of these 31 children, 13 had further neurologic deterioration and the conditions of three improved. Seventeen children had a static course with cognitive deficits (seven children) or cognitive plus neurologic impairment (ten children). Neuroradiologic studies in the children with a subacute progressive or plateau course disclosed cerebral atrophy, white matter abnormalities, and calcification of the basal ganglia. Postmortem findings included variable degrees of inflammatory response, multinucleated cells, calcific vasculopathy, and pyramidal tract degeneration. Computed tomographic studies of the children with a static course were normal or showed mild atrophy, but poor brain growth was documented by serial head circumference measurements.

(AJDC 1988:142:29-35)

Author Affiliations
From the Department of Neurology, SUNY, Stony Brook, NY (Dr Belman); and the Departments of Neurology (Dr Belman), Pediatrics (Drs Diamond and Rubinstein), Pathology (Drs Dickson, Horoupian, and Llena), and Radiology (Dr Lantos), Albert Einstein College of Medicine/Montefiore Hospital and Medical Center, Bronx, NY.

Footnotes
Accepted for publication Aug 13, 1987.

Presented at the Third International Conference on AIDS, Washington, DC, June 3, 1987.

Reprint requests to Department of Neurology, Health Science Center T-12-020, SUNY, Stony Brook, NY 11794 (Dr Belman).

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