HIV-associated myelopathy: an uncommon revelation of AIDS.

Introduction. - Spinal cord lesions are an uncommon mode of discovering acq uired immunodeficiency syndrome because they usually appear at a later stag e. Exegesis. - We report a 58-year-old patient who had a spastic paraparesia a nd sphincter dysfunction. The spinal cord magnetic resonance imaging showed spontaneous hypersignals on T2-weighted images at the cervical and thoraci c levels, enhanced with gadolinium, and without swelling. No cause was foun d. The HIV serology was positive and allowed us to consider an HIV-associat ed myelopathy The antiretroviral therapy led to functional recovery. Conclusion. - An HIV serology is suggested whenever an unexplained intramed ullary lesion is discovered. Indeed, the diagnosis of HIV-associated myelop athy implies a specific therapeutic approach. (C) 2001 Editions scientifiqu es et medicales Elsevier SAS.