scholarly journals HIV-Associated Vacuolar Myelopathy and HIV-Associated Dementia as the Initial Manifestation of HIV/AIDS

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Natalia Wuliji ◽  
Matthew J. Mandell ◽  
Jason M. Lunt ◽  
Adam Merando
Keyword(s):  
Neurological Diseases ◽  
Spastic Paraparesis ◽  
Memory Loss ◽  
Vitamin B12 Deficiency ◽  
Sensory Neuropathy ◽  
Ataxic Gait ◽  
Subacute Combined Degeneration ◽  
Initial Manifestation ◽  
Vacuolar Myelopathy ◽  
Hiv Aids

HIV-associated vacuolar myelopathy (HIV-VM) is the most common cause of spinal disease in HIV/AIDS. HIV-VM causes progressive spastic paraparesis, sensory ataxia, and autonomic dysfunction. It is a progressive myelopathy that shares features with subacute combined degeneration seen in vitamin B12 deficiency as well as other neurological diseases and can occur synchronously with HIV-associated dementia (HAD). Here, we describe a rare case in which a patient’s initial presentation of HIV/AIDS was both HIV-VM and HAD. A fifty-three-year-old man presented with a six-month history of numerous falls due to progressive gait instability with associated memory loss, tremor, urinary retention, and impotence. His exam was significant for hyperreflexia and weakness in bilateral lower extremities, upgoing plantar reflex, dysmetria, and ataxic gait. MRI-brain was notable for nonspecific volume loss and diffusely increased T2 signal throughout the supratentorial white matter. Lumbar puncture showed isolated lymphocytic pleocytosis with all other CSF testing unremarkable. He ultimately tested positive for HIV-1, with a CD4 count of 157 cells/mm3 and a viral load of 874,000 copies/mL. He was diagnosed with HIV-VM and HAD which improved after several months of antiretroviral therapy. This case highlights the importance of considering HIV testing in a patient with a sensory neuropathy and/or progressive cognitive impairment.

scholarly journals The effectiveness of Bacopa monnieri (Linn.) Wettst. as a nootropic, neuroprotective, or antidepressant supplement: analysis of the available clinical data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
James M. Brimson ◽  
Sirikalaya Brimson ◽  
Mani Iyer Prasanth ◽  
Premrutai Thitilertdecha ◽  
Dicson Sheeja Malar ◽  
...  
Keyword(s):  
Plant Extracts ◽  
Neurological Diseases ◽  
Digit Span ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Memory Loss ◽  
Learning Task ◽  
Inspection Time ◽  
Neuroprotective Effects

AbstractBacopamonnieri (Linn.) Wettst. has been used in traditional medicine as a drug to enhance and improve memory. In this regard, this study aims to provide B. monnieri's efficacy as a neuroprotective drug and as a nootropic against various neurological diseases. Literatures were collected, following Prisma guidelines, from databases, including Scopus, PubMed, Google Scholar, and Science Direct and were scrutinized using a quality scoring system. Means, standard deviations and ‘n’ numbers were extracted from the metrics and analyzed. Jamovi computer software for Mac was used to carry out the meta-analysis. The selected studies suggested that the plant extracts were able to show some improvements in healthy subjects which were determined in Auditory Verbal Learning Task, digit span-reverse test, inspection time task and working memory, even though it was not significant, as no two studies found statistically significant changes in the same two tests. B. monnieri was able to express modest improvements in subjects with memory loss, wherein only a few of the neuropsychological tests showed statistical significance. B. monnieri in a cocktail with other plant extracts were able to significantly reduce the effects of Alzheimer’s disease, and depression which cannot be solely credited as the effect of B. monnieri. Although in one study B. monnieri was able to potentiate the beneficial effects of citalopram; on the whole, currently, there are only limited studies to establish the memory-enhancing and neuroprotective effects of B. monnieri. More studies have to be done in the future by comparing the effect with standard drugs, in order to establish these effects clinically in the plant and corroborate the preclinical data.

Human T Lymphotropic Virus Type I (Htlv-I)-Specific T Helper Cell Responses from Htlv-I Seronegative Patients with Chronic Myelopathy and Ms in Japan

1996 ◽  
Vol 1 (4) ◽  
pp. 200-203
Author(s):  
M Nishimura ◽  
S Jacobson ◽  
T Uchiyama ◽  
M Ohta ◽  
T Saida
Keyword(s):  
Virus Type ◽  
Neurological Diseases ◽  
Interleukin 2 ◽  
Spastic Paraparesis ◽  
Peripheral Blood Lymphocytes ◽  
Type I ◽  
T Lymphotropic Virus ◽  
Adult T Cell Leukemia ◽  
Progressive Myelopathy ◽  
Chronic Myelopathy

Human T lymphotropic virus type I (HTLV-I) is a human retrovirus etiologically linked to Adult T cell leukemia (ATL) and HTLV-I associated myelopathyltropical spastic paraparesis (HAM/TSP). Although most HAM/TSP patients have high anti-HTLV-I antibody titers in their sera, HTLV-I infected but seronegative patients with neurological diseases have been reported. To clarify whether seronegative, HTLV-I related neurological disease may exist, we have developed a method that measures the production of interleukin-2 (IL-2) from HTLV-I synthetic peptide-stimulated peripheral blood lymphocytes (PBL) of HTLV-I infected persons. This method is sensitive enough to detect exposure to HTLV-I before seroconversion or even before detection by PCR. We examined 12 patients with chronic progressive myelopathy and eight patients with multiple sclerosis (MS) in central Japan, where the prevalence rate of HTLV-I is between one and four percent among asymptomatic blood donors, using the IL-2 production assay. None of them were positive by the assay, suggesting seronegative HTLV-I myelopathy is very rare among patients with chronic progressive myelopathy and MS in Japan.

scholarly journals The Level of Serum Pepsinogen in Diagnosing and Evaluating the Severity of Subacute Combined Degeneration Due to Vitamin B12 Deficiency

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyan Chen ◽  
Rong Wang ◽  
Xusheng Huang ◽  
Fei Yang ◽  
Shengyuan Yu
Keyword(s):  
Vitamin B12 ◽  
Neurological Complication ◽  
Vitamin B12 Deficiency ◽  
Inverse Correlation ◽  
Cobalamin Deficiency ◽  
Serum Pepsinogen ◽  
Roc Curve Analysis ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency ◽  
Autoimmune Atrophic Gastritis

Subacute combined degeneration (SCD) is a neurological complication of cobalamin deficiency, which is usually caused by chronic autoimmune atrophic gastritis. Serum pepsinogen 1 and the ratio of pepsinogen 1/pepsinogen 2 (PG1/2) can reflect the severity of gastric atrophy.Objective: This work aims to investigate whether decreased serum PG1 and PG1/2 ratio are helpful in diagnosing SCD and reflecting the severity of SCD.Methods: We retrospectively analyzed the clinical and laboratory tests of 65 cases of SCD due to vitamin B12 deficiency and compared the laboratory parameters of SCD with 65 age- and sex-matched amyotrophic lateral sclerosis (ALS) patients.Results: PG1 and PG1/2 ratio were decreased in 80 and 52.3% of SCD patients, respectively. Compared to patients with PG1/2 ratio ≥3.0, patients with PG1/2 ratio <3.0 had more severe anemia, larger mean corpuscular volume (MCV), lower level of vitamin B12, higher folate and homocysteine (Hcy), more severe changes in somatosensory evoked potential (SEP), and higher rate of lesions in spinal MRI (P < 0.05). PG1 and PG1/2 ratio had inverse correlation with MCV and N20 latency in SEP examination (P < 0.05). PG1/2 ratio, RBC count, and Hcy were independent risk factors for SCD in logistic regression analyses. The ROC curve analysis revealed that the diagnostic accuracy of PG1 and PG1/2 ratio was 72.2 and 73.0%, respectively, while the cutoff values were 22.4 ng/ml and 2.43 for SCD, respectively.Conclusions: Decreased PG1 and PG1/2 ratio are helpful for the diagnosis and evaluation of the severity of SCD due to vitamin B12 deficiency.

Subacute Combined Degeneration of the Spinal Cord and Hydrocephalus Associated with Vitamin B12 Deficiency

2019 ◽  
Vol 128 ◽  
pp. 277-283 ◽  
Author(s):  
Wei Sun ◽  
Guangsheng Li ◽  
Zhaohui Lai ◽  
Zhijuan Lu ◽  
Ye Lin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency

scholarly journals Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord

2013 ◽  
Vol 2013 (sep29 1) ◽  
pp. bcr2013200380-bcr2013200380 ◽  
Author(s):  
H. B. Gowdappa ◽  
M. Mahesh ◽  
K. V. K. S. N. Murthy ◽  
M. G. Narahari
Keyword(s):  
Spinal Cord ◽  
Helicobacter Pylori ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Pernicious Anaemia ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency

scholarly journals Subacute Combined Degeneration of the Spinal Cord due to Different Etiologies and Improvement of MRI Findings

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Azize Esra Gürsoy ◽  
Mehmet Kolukısa ◽  
Gülsen Babacan-Yıldız ◽  
Arif Çelebi
Keyword(s):  
Spinal Cord ◽  
Nitrous Oxide ◽  
Vitamin B12 ◽  
Neurological Complication ◽  
Vitamin B12 Deficiency ◽  
Vegetarian Diet ◽  
Mri Findings ◽  
Subacute Combined Degeneration ◽  
B12 Deficiency ◽  
Reversible Condition

Subacute combined degeneration (SCD) is a rare neurological complication of vitamin B12 deficiency, characterized by demyelination of the dorsal and lateral spinal cord. Herein, we describe three cases, who presented with SCD, one related to reduced intake of vitamin B12 because of a vegetarian diet and two related to nitrous oxide exposure during surgery. MR images of our patients revealed symmetrical hyperintense signals in dorsal and lateral columns in T2 weighted series. After treatment with intramuscular B12 injections (1 mg daily for 2 weeks, once weekly thereafter for three months) all patients showed improvement of their symptoms. Abnormalities of the spinal cord on MRI resolved in three months. In conclusion, SCD either due to nitrous oxide exposure or due to reduced intake of vitamin B12 is a reversible condition, when detected and treated early.

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