CYTOMEGALOVIRUS MULTIFOCAL NEUROPATHY WIT H PARALYZED LEFT TRUE VOCALCORD IN A PATIENT WITH AIDS

Cytomegalovirus multifocal neuropathies (CMV-MN) in patients with AIDS are much less frequent than meningoradiculitis. We report here the ca se of a patient with AIDS hospitalized because of a severe motor weakn ess and paralyzed left true vocal cord (PVC), related to a multifocal neuropathy, CSF analysis was normal with a negative PCR for CMV, but n euromuscular biopsy showed typical CMV inclusions. The patient's condi tion improved with high dose foscarnet therapy, followed by a combinat ion of ganciclovir plus foscarnet, during a five-month follow-up perio d. Twenty three case reports of CMV-MN have been published in the lite rature, only 2 of them presenting with a PVC. Extraneurological CMV in volvment was usually documented. PCR for CMV in CSF was most often pos itive. However CMV inclusions were not frequently observed. The patien ts were usually improved under therapy with usually ganciclovir but re lapse was observed in fifty percent within 3 to 6 months despite secon dary prophylaxis.