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July 1989

Treatable Causes of Meningomyeloradiculitis in Individuals Infected With Human Immunodeficiency Virus

Author Affiliations

Department of Neurology University Hospitals of Cleveland Cleveland, OH 44106

Arch Neurol. 1989;46(7):722-723. doi:10.1001/archneur.1989.00520430016009

To the Editor.  —Woolsey and colleagues1 reported an interesting case of mycobacterial meningomyeloradiculitis in a man infected with human immunodeficiency virus. Since submission of their report, several other treatable causes of this syndrome in individuals infected with the human immunodeficiency virus have been reported, including syphilis2,3 and leptomeningeal malignancy.4 Treatable causes of other myelopathic syndromes have also been reported.5,6Patients infected with human immunodeficiency virus who develop meningomyeloradiculitis have presented a remarkably uniform and distinct clinical profile.1-4,7-9 Generally, asymmetric leg weakness develops over several weeks to months, often associated with burning or aching pain in the legs and buttocks. There is frequently early sphincter involvement. Examination reveals flaccid paraparesis, areflexia in the affected extremities, and diffuse or patchy hypesthesias in the legs and saddle area. Babinski's sign is present in some cases. Involvement may progress through contiguous segments to thoracic or even cervical levels. Myelograms

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