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Cognitive and Radiologic Improvement After Antiretroviral Therapy

Marcus Tulius T. Silva, MD, PhD; Sandra Wagner, MD, PhD; Beatriz Grinsztejn, MD, PhD

Arch Neurol. 2009;66(8):1040-1041.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In October 2007, a 41-year-old human immunodeficiency virus (HIV)–positive Brazilian woman was admitted to the hospital because of mild gait disturbance and difficulty in memory and concentration. She had a recent history of weakness, oral candidiasis, and weight loss. Neurologic examination revealed brisk tendon reflexes in the upper and lower limbs, sluggishness of ocular persecutory movements, unsteady gait, and slowness of alternated fast movements. A brief neuropsychological assessment of the patient revealed psychomotor slowness and diminished verbal fluency (Table). Her CD4 cell count and HIV viral load were 71/µL and 851.569 copies/mL (5.9 log), respectively. Brain magnetic resonance imaging (MRI) revealed diffuse white matter abnormalities without gadolinium enhancement (Figure, A). Cerebrospinal fluid analysis revealed 2 cells/µm³ (100% mononuclear), a glucose level of 46 mg/dL (to convert glucose to millimoles per liter, multiply . . . [Full Text of this Article]

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