Subclinical peripheral nerve involvement in AIDS: an electrophysiological and pathological study
| Autor: | R J Guiloff, G N Fuller, J M Jacobs |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Neuromuscular Junction Sural nerve Electromyography Synaptic Transmission Sudden death Asymptomatic Gastroenterology Nerve conduction velocity Mononeuropathy Death Sudden Internal medicine Reaction Time medicine Humans Peripheral Nerves Subclinical infection Acquired Immunodeficiency Syndrome medicine.diagnostic_test business.industry Peripheral Nervous System Diseases Middle Aged medicine.disease Axons Electric Stimulation Microscopy Electron Psychiatry and Mental health Peripheral neuropathy Nerve Degeneration Female Surgery Neurology (clinical) medicine.symptom business Research Article |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 54:318-324 |
| ISSN: | 0022-3050 |
| Popis: | Thirty patients with AIDS without symptoms or signs of peripheral neuropathy were compared electrophysiologically with 23 age and sex matched healthy controls. The patients had a mean reduction in the amplitude of common peroneal compound muscle action potentials of 37% (95% CI 11-70%) and of sural sensory action potentials of 34% (CI 18-49%). Mean conduction velocity of both motor and sensory nerves was reduced by between 1 and 7 m/s, with a prolongation of F waves corrected for height of 5% in the arms and 13% in the legs. The distal motor latencies were unchanged. These changes did not correlate with the duration of AIDS, degree of immunosuppression (CD4 count), Body Mass Index, albumin or vitamin B12 level. Four patients had subclinical mononeuropathies. Sural nerve taken at necropsy from five asymptomatic AIDS patients had evidence of axonal degeneration without inflammation or demyelination. There was a mean reduction in myelinated fibre density of 30.5% (CI 10-51%) compared with eight age matched sudden death controls (p = 0.01). This loss principally affected the larger fibres. The pathological and electrophysiological changes indicate axonal degeneration and are similar to those seen in other chronic disorders and in normal ageing. It is concluded that this axonal degeneration is not specific to HIV. |
| Databáze: | OpenAIRE |
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