       Document 0745
 DOCN  M9590745
 TI    [Lesions of the conus medullaris and the cauda equina caused by
       cytomegalovirus in HIV infection. 7 cases]
 DT    9509
 AU    Jacomet C; Lebrette MG; el Amrani M; Monfort L; Gozlan J; Girard PM;
       Rozenbaum W; Service des Maladies infectieuses et tropicales, Hopital;
       Rothschild, Paris.
 SO    Presse Med. 1995 Mar 18;24(11):527-30. Unique Identifier : AIDSLINE
       MED/95288213
 AB    OBJECTIVES: Neurologic infections caused by cytomegalovirus are common
       in patients with acquired immunodeficiency syndrome (AIDS). The
       prognosis is particularly severe when the infection is localized in the
       conus medullaris and/or the cauda equina. METHODS: Among the 861
       patients with AIDS treated in our unit from 1991 to 1993, 7 cases
       involving cytomegalovirus infection of the conus medullaris and/or the
       cauda equina were studied retrospectively. RESULTS OF THE CASE REPORTS:
       Clinical manifestations were nearly always the same: low back pain,
       motor deficiency in the lower limbs progressing to flaccid paraplegia
       and sphincter failure. The cerebrospinal fluid contained a high cell
       count with unaltered polynuclears and increased protein levels. In 6/7
       patients virus cultures and search for the viral genome in the
       cerebrospinal fluid were positive. The clinical course was favourable in
       6 patients after 3 weeks treatment with ganciclovir and/or foscarnet.
       Virology tests became negative in three-fourths of the patients.
       Nevertheless, relapse occurred after 4.2 weeks despite long-term
       therapy. CONCLUSION: The severe clinical course of this disease and the
       gravity of constantly fatal relapse requires highly adapted treatment
       and overall health care.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  AIDS-Related
       Opportunistic Infections/DRUG THERAPY/*VIROLOGY  Case Report  Cauda
       Equina/*VIROLOGY  Cytomegalovirus Infections/*COMPLICATIONS/DRUG
       THERAPY/VIROLOGY  Drug Therapy, Combination  English Abstract  Fatal
       Outcome  Female  Foscarnet/THERAPEUTIC USE  Ganciclovir/THERAPEUTIC USE
       Human  HIV Infections/*COMPLICATIONS  Male  Middle Age  Nerve
       Compression Syndromes/DRUG THERAPY/ETIOLOGY/*VIROLOGY  Retrospective
       Studies  Spinal Nerve Roots/*VIROLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

