Stroke and seizures as the presenting signs of pediatric HIV infection

The authors report two pediatric patients with definite human immunodeficie ncy virus infection whose initial presentation was stroke and seizure. The first patient was a 3-year-old female who developed acute hemiparesis as th e first manifestation. The other, a 2-month-old infant, had focal seizures secondary to cerebral infarction, Investigations revealed ischemic infarcti on of the thalamus, hypothalamus, and internal capsule in the first patient and cerebral cortex in the second. Further investigations failed to demons trate any other causes of these cerebral infarctions. Opportunistic infecti on of the central nervous system was nob documented, The authors emphasize that cerebrovascular accident may be the initial presentation in human immu nodeficiency virus infection in children. Human immunodeficiency virus infe ction must be included in the differential diagnosis, and testing for the d isease is mandatory in the investigation of stroke in any child who is at r isk of having this infection. (C) 1999 by Elsevier Science Inc. All rights reserved.