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.