Acute Lumbosacral Polyradiculopathy in Acquired Immunodeficiency Syndrome:Experience in 23 Patients

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Acute Lumbosacral Polyradiculopathy in Acquired Immunodeficiency Syndrome:Experience in 23 Patients
Ann Neurol 35:53-58, So,Y.T.&Olney,R.K., 1994 See this aricle in Pubmed

Article Abstract
We reviewed our experience in 23 patients with acquired immunodeficiency syndrome(AIDS)who had acute lumbosacral polyradiculopathy.The patient developed a distinctive syndrome of rapidly progressive flaccid paraparesis and areflexia that was frequently associated with sphincter disturbances.Persuasive laboratory evidence of a cytomegalovirus polyradiculopathy(polymorphonuclear pleocytosis or confirmatory cerebrospinal fluid culture)was found in 15 of the 23 patients.Treatment with ganciclovir in these patients led to clinical stabilization,although worsening during the first 2 weeks of treatment was common.Most patients with cytomegalovirus polyradiculopathy had severe residual deficits. Metastasis from systemic lymphoma accounted for the polyradiculopathy in 2 other patients.A more benign syndrome was identified in the remaining 6 patients.They generally had slower clinical progression and less severe neurological deficits at their nadir than did patients with cytomegalovirus polyradiculopathy.Unlike patients with cytomegalovirus infection,their cerebrospinal fluid showed a predominantly mononuclear pleocytosis.Moreover,spontaneous improvement without treatment was common. Our experience together with the published experience of others suggests that the acute lumbosacral polyradiculopathy in AIDS is a clinical syndrome with different etiologies and variable clinical outcome. Recognition of this heterogeneity is necessary for the management of individual patients,as well as the interpretation of treatment results.

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