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Spinal cord degeneration in AIDS

Department of Neurology (Dr. Goldstick), the Department of Pathology and Laboratory Medicine (Dr. Mandybur), and the Department of Internal Medicine (Dr. Bode), University of Cincinnati College of Medicine, Cincinnati, OH.

Ten months before his death, a 36-year-old homosexual man with AIDS developed progressive symmetric paraparesis with muscle wasting, paresthesias, reflex-uninhibited bladder function, and bowel incontinence. Neuropathologic postmortem examination revealed a symmetric degeneration of the lateral and anterior pyramidal tracts as well as the posterior columns. Scattered microglial nodules were present in the brain and spinal cord. The cause of this spinal cord complication remains uncertain. Possible etiologies of the demyelinating process include infectious, parainfectious, nutritional, paraneoplastic, and toxic causes.

Address correspondence and reprint requests to Dr. Mandybur, Department of Pathulogy (Neuropathology), Mail Location 533, University of Cincinnati Medical Center, Cincinnati, OH 45267.

Accepted for publication April 13, 1984

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