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fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Sloan Derek J; Nicolson Andrew; Miller Alastair RO; Beeching Nick J; Beadsworth Mike BJ (2008)
Publisher: BioMed Central
Journal: Journal of Medical Case Reports
Languages: English
Types: Article
Subjects: RC0321, R, Human immunodeficiency virus testing, RA0421 Public health. Hygiene. Preventive Medicine, RA0421, Human immunodeficiency virus, Case Report, Medicine, Intravenous immunoglobulin therapy, Acute inflammatory demyelinating polyneuropathy, Efavirenz, RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry

Abstract

Introduction

Acute Human Immunodeficiency Virus infection is associated with a range of neurological conditions. Guillain-Barré syndrome is a rare presentation; acute inflammatory demyelinating polyneuropathy is the commonest form of Guillain-Barré syndrome. Acute inflammatory demyelinating polyneuropathy has occasionally been reported in acute Immunodeficiency Virus infection but little data exists on frequency, management and outcome.

Case presentation

We describe an episode of Guillain-Barré syndrome presenting as acute inflammatory demyelinating polyneuropathy in a 30-year-old man testing positive for Immunodeficiency Virus, probably during acute seroconversion. Clinical suspicion was confirmed by cerebrospinal fluid analysis and nerve conduction studies. Rapid clinical deterioration prompted intravenous immunoglobulin therapy and early commencement of highly active anti-retroviral therapy. All symptoms resolved within nine weeks.

Conclusion

Unusual neurological presentations in previously fit patients are an appropriate indication for Immunodeficiency-Virus testing. Highly active anti-retroviral therapy with adequate penetration of the central nervous system should be considered as an early intervention, alongside conventional therapies such as intravenous immunoglobulin.

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