- Common complication in late AIDS
- Spectrum from subtle deficits to HIV-Associated Dementia
- Higher severity (including Dementia) with decreasing CD4 Counts
- Involves three neurologic domains
- Cognitive (memory, concentration, planning, comprehension)
- Behavioral (apathy, depression, Agitation)
- Motor (Incoordination, unsteady gait, Tremor)
- Early
- Impaired concentration
- Forgetfulness
- Slowed cognitive function
- Late
- Impaired rapid movements
- Hyperreflexia
- Release reflexes
- Weakness
- Ataxia
- Spasticity
- Bladder and bowel Incontinence
- Myoclonus
- See Dementia Causes
- See Delirium
- Toxoplasmosis
- Progressive Multifocal Leukoencephalopathy (PML)
- Primary Lymphoma
- Meningitis
- Neurosyphilis
- Psychiatric conditions
- Substance Abuse
- Brain MRI findings
- Cerebral atrophy
-
Patchy, diffuse increased white matter signal intensity
- Excludes other causes
- Mildly elevated Protein
- Mild Pleocytosis, predominance of mononuclear cells
- Montreal Cognitive Assessment (MoCA)
- Neuropsychiatric testing
-
Antiretroviral drugs
- May improve neuropsychiatric performance
- May alleviate symptoms
- Poor compliance with Antiretroviral therapy (with risk of resistance)
- Decreased functional capacity