EARLY DETECTION OF DISTAL SYMMETRICAL POLYNEUROPATHY DURING HIV-INFECTION BY PAIRED STIMULATION OF SURAL NERVE

In 203 HIV infected patients in Various clinical stages neurological e xamination, paired stimulation (LPSS), nerve conduction velocity (NCVS ) and amplitude (AMPS) of the sural nerve, distal latency (DLP), nerve conduction velocity (NCVP), amplitude (AMPP) and F waves of the peron eal nerve were recorded. Neurological examination revealed symptoms an d clinical signs of polyneuropathy in 67 (33%) (WR 1-6) of the patient s. LPSS after paired stimulation was abnormal in 25.5%, NCVS in 14.2%, AMPS in 9.8%, NCVP in 11.8%, DLP in 11.2%, AMPP in 5.9% and FWP in 14 .6%. Our findings indicate a high incidence of peripheral nerve system involvement during HIV infection. In 11.5% of all patients only LPSS proved polyneuropathy. Neurophysiological results from HIV infected pa tients with symptoms and clinical signs of polyneuropathy were statist ically significantly different from HIV infected patients without symp toms and clinical signs of polyneuropathy. The delay of LPSS represent s the most sensitive neurophysiological indicator of polyneuropathy du ring HIV infection and announces the onset of peripheral nerve disease even in early stages of infection, according to Waiter Reed staging c lassification 1 and 2 (approx 20%).