%0 Journal Article
%T Human immunodeficiency virus seroconversion presenting with acute inflammatory demyelinating polyneuropathy: a case report
%A Derek J Sloan
%A Andrew Nicolson
%A Alastair RO Miller
%A Nick J Beeching
%A Mike BJ Beadsworth
%J Journal of Medical Case Reports
%D 2008
%I BioMed Central
%R 10.1186/1752-1947-2-370
%X We describe an episode of Guillain-Barr¨¦ 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.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.Human Immunodeficiency Virus (HIV) infection is neurotropic and a wide array of neurological presentations has been described. Alongside common presentations of meningitis, encephalitis and peripheral neuropathies, Guillain-Barr¨¦ syndrome (GBS) has rarely been reported. Fewer reports exist of the acute inflammatory demyelinating polyneuropathy (AIDP) variant of GBS presenting as an acute HIV seroconversion. Little data exists on patient outcomes or treatment options in HIV-GBS, including intravenous immunoglobulin (IVIg) and highly active anti-retroviral therapy (HAART). We discuss the clinical presentation, outcome and management including the current evidence base.In 2007 a previously well 30-year-old homosexual man presented with a 5 day history of progressive bilateral ascending lower limb weakness, preceded by a flu-like illness lasting for 2 weeks. Examination revealed normal tone but slightly reduced power at Medical Research Council (MRC) grading 4/5 [1]. Sensation was intact but he was areflexic in both legs. Plantar responses were flexor. The rest of the clinical examination was normal.Cerebrospinal fluid (CSF) examination showed 26 leucocytes/mm
%U http://www.jmedicalcasereports.com/content/2/1/370