The clinical spectrum of neurological manifestations in AIDS patients in Mexico

Background. Neurological complications may be present clinically in up to 3 9% of patients infected with HIV or AIDS. Some reports have shown different profiles of neurological illness related to geographic variations and the population studied. Methods. This retrospective study describes the neurological manifestations of patients with AIDS seen between 1990 and 1998 at a single neurological referral hospital in Mexico City. Results, One hundred forty-nine patients were included, 133 males (89%) and 16 females (10.7%). The average age was 33.8 years (9 to 75 years). Upon a dmission, only 50 patients (33.6%) were known to be seropositive to HIV-1, In 75 patients (50.3%), the neurological illness was definitory of AIDS and also was its first recognized clinical manifestation. The most common infe ction problems were brain toxoplasmosis (32.2%), meningeal cryptococcosis ( 21.5%), tuberculosis (8.7%), and AIDS-dementia complex (8.7%). There were e ight (5.4%) cases of ischemic cerebrovascular disease and four (2.7%) neopl asms. Two primary brain lymphomas and single cases of astrocytoma and oligo dendroglioma, progressive multifocal leukoencephalopathy (PML), aseptic men ingitis, acute encephalitis, transverse myelitis, myopathy, and cranial neu ropathy were also seen. Conclusions. In comparison with other studies of neurological complications of AIDS, opportunistic infections amenable to treatment in our population were more common. A high case fatality rate was observed, as was a large pr oportion of patients in whom the neurological illness was the first manifes tation of HIV infection or AIDS due to denied, unknown, or unrecognized ris k factors for HIV infection. (C) 2000 IMSS. Published by Elsevier Science I nc.