PROGRESSIVE PERIPHERAL AND CENTRAL SENSORY TRACT LESION IN HIV-INFECTED PATIENTS EVIDENCED BY EVOKED-POTENTIALS (A 3-YEAR FOLLOW-UP-STUDY)

Objective: to investigate progression of peripheral and central sensor y trace lesion and its correlation to immunological deterioration. Met hods: clinical and neurophysiological investigation (evoked potentials of the median and tibial nerve) and immunological parameters (CD4-cel ls, beta(2)-microglobuline) were followed up in 160 patients (24 femal es, 136 males, HIV infection for 2.7+/-2.3 years, mv+/-1 sd) up to fou r times over similar to 3 years regardless of disease stage and eviden ce of neurological symptoms. Recordings were done using needle electro des over the Th12 and C7 spinous process and from the scalp (10/20 sys tem) in the conventional manner. Statistical analysis was performed in traindividually and in comparison to normal laboratory values (n=96). Results: All parameters deteriorated during the follow-up period. Stat istical analysis showed significant differences between probands and p atients for evoked potentials, but also a significant deterioration fo r evoked potentials after three years at the end of the follow-up stud y. A significant correlation between progressive impairment of evoked potentials and laboratory data was found. Conclusion: HIV infection in duces a progressive lesion of the ascending sensory tracts. The result s indicate a peripheral neuropathy as well as a progressive lesion of the ascending central sensory tracts. Pathogenesis of polyneuropathy a nd of central sensory tract lesion is up to now conjectural. Laborator y investigations indicate a clear-cut correlation between immunologica l alterations induced by HIV infection and its neurologic manifestatio n on ascending sensory tracts. (C) 1998 Elsevier Science B.V. All righ ts reserved.