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AIDS Dementia ComplexAka: Dementia in HIV

Epidemiology
1. Common complication in late AIDS
Pathophysiology
1. Cognitive, behavioral, and motor dysfunction
Signs
1. Early
  1. Impaired concentration
  2. Forgetfulness
  3. Slowed cognitive function
2. Late
  1. Impaired rapid movements
  2. Hyperreflexia
  3. Release reflexes
  4. Weakness
  5. Ataxia
  6. Spasticity
  7. Bladder and bowel Incontinence
  8. Myoclonus
Differential Diagnosis
1. Toxoplasmosis
2. PML
3. Primary Lymphoma
4. Meningitis
5. Neurosyphilis
Neuroimaging
1. Cerebral atrophy
2. Patchy, diffuse increased white matter signal intensity
  1. Excludes other causes
Labs: CSF Exam
1. Mildly elevated protein
2. Mild Pleocytosis, predominance of mononuclear cells
Management: Anti-HIV drugs (AZT)
1. May improve neuropsychiatric performance
2. May alleviate symptoms

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This page was written by Scott Moses, MD. This page was last revised on 3/7/2008 9:49:49 AM. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.