Reversible myoclonic encephalopathy revealing the AIDS-dementia complex |
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| Affiliation: | 1. Department of Neurology, Edward B. Bromfield Epilepsy Center, Brigham and Women''s Hospital, Boston, 75 Francis Street, Boston, MA 02115, USA;2. Department of Neurology, Massachusetts General Hospital, Boston, 55 Fruit Street, Boston, MA 02114, USA;3. Department of Psychiatry, Massachusetts General Hospital, Boston, 55 Fruit Street, Boston, MA 02114, USA |
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| Abstract: | A 40-year-old HIV-positive right handed homosexual man was admitted for progressive mental deterioration coexisting with permanent segmental middle-amplitude arrhythmic, asynchronous and asymmetrical myoclonic jerks. EEG showed fronto-central bursts of rhythmic triphasic 1.5–2 Hz sharp waves similar to the characteristics periodic pattern of Jakob-Creutzfeldt disease. Biological procedures were negative, thus eliminating a metabolic encephalopathy. Dramatic neurological improvement occurred shortly after initiation of i.v. and then oral zidovudine which produced perfect EEG normalisation. This unusual electroclinical presentation of the AIDS-dementia complex underlines the fact that this affection may present a diagnostic challenge, particularly in individuals in whom HIV infection is unknown. |
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