Page 319 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 6 Original Research

Motor lumbosacral radiculopathy

in HIV-infected patients

Authors: Background: This study is a review of the clinical findings and treatment outcome of 11
Kaminie Moodley 1 HIV-infected patients with motor lumbosacral radiculopathy.
Pierre L.A. Bill 1
Vinod B. Patel 1 Objectives: To describe the clinical, laboratory, electrophysiological features and treatment
outcome in HIV-infected motor lumbosacral radiculopathy which is a rare manifestation
Affiliations:
1 Department of Neurology, of HIV.
University of KwaZulu-Natal,
Durban, South Africa Method: A retrospective review of HIV-infected patients with motor lumbosacral radiculopathy
was performed at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa
Corresponding author: between 2010 and 2015.
Kaminie Moodley,
[email protected] Results: Eleven black African patients met the inclusion criteria. There were six women. The
median age was 29 years, the interquartile range (IQR) was 23–41 years, the median duration
Dates:
Received: 12 June 2019 of symptom progression was 6.5 months (IQR 3–7.5 months). The median CD4 count was
Accepted: 31 July 2019 327 cells/µL (IQR 146–457). The cerebrospinal fluid (CSF) median polymorphocyte count was
Published: 28 Oct. 2019 0 cells/µL (IQR 0 cells/µL – 2 cells/µL), lymphocyte count was 16 cells/µL (IQR 1 cells/µL –
18 cells/µL), glucose level was 3.1 mmol/L (IQR 2.8 mmol/L – 3.4 mmol/L) and protein level
How to cite this article:
Moodley K, Bill PLA, was 1.02 g/dL (IQR 0.98 g/dL – 3.4 g/dL). All patients were treated with corticosteroid
Patel VB. Motor lumbosacral therapy. Ninety-one per cent recovered fully within 6 months of treatment, the median time
radiculopathy in HIV-infected for recovery was 3.4 months (IQR 1.8–5.6 months). There were no relapses during the 18-month
patients. S Afr J HIV Med. follow-up.
2019;20(1), a992. https://doi.
org/10.4102/sajhivmed. Conclusion: HIV-infected patients with motor lumbosacral radiculopathy responded to
v20i1.992
corticosteroids, with no relapses during the 18-month follow-up period.
Copyright: Keywords: HIV; lumbosacral radiculopathy; ART; corticosteroids; treatment outcome.
© 2019. The Authors.
Licensee: AOSIS. This work
is licensed under the
Creative Commons Introduction
Attribution License.
Progressive lumbosacral polyradiculopathy is a well-described complication of late HIV infection
and is usually caused by opportunistic infections such as cytomegalovirus (CMV), herpes simplex
virus (HSV), varicella zoster virus (VZV), Ebstein-Barr virus (EBV), syphilis, tuberculosis (TB),
cryptococcus and, less commonly, lymphoma, paraneoplastic polyradiculopathy, chronic
inflammatory demyelinating polyradiculopathy (CIDP), or diffuse infiltrative lymphocytosis
(DILS). 1,2,3 Infective aetiologies, lymphoma and paraneoplastic polyradiculopathy are usually
subacute and are progressive unless treated. 1,3,4,5,6,7

In 2000, Benatar et al. described four HIV-infected patients who presented with acute or subacute
weakness with spontaneous recovery. Infective and inflammatory aetiologies were excluded.
8
This entity was described as a ‘unique’ clinical entity in the setting of HIV or a ‘variant of Guillain–
Barre syndrome (GBS)’. Since 2000, there were no further documented cases in the literature.
8

Between 2010 and 2015, we retrospectively identified a similar cohort of 11 HIV-infected patients
who presented with a motor lumbosacral radiculopathy. In this article, we add to the current
literature regarding this unusual group of patients by describing the clinical presentation,
demographic features, electrodiagnostic, radiological, cerebrospinal fluid (CSF) findings and
response to therapy.
Read online: Methods
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code with your
code with your
smart phone or Patients were identified between 2010 and 2015 in the Department of Neurology at Inkosi Albert
smart phone or
mobile device Luthuli Central Hospital, which is a 1000-bed tertiary hospital in Durban, KwaZulu-Natal province,
mobile device
to read online.
to read online.
South Africa. The Department of Neurology attends approximately 8000 patients per year.
http://www.sajhivmed.org.za 312 Open Access