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NEUROLOGY 1987;37:557
© 1987 American Academy of Neurology

Cytomegalovirus polyradiculoneuropathy in acquired immune deficiency syndrome

Roger Behar, MD, Clayton Wiley, MD and J. Allen McCutchan, MD

Departments of Neurology, Pathology, and Medicine, University of California, San Diego, CA.

A 34-year-old homosexual man with acquired immune deficiency syndrome developed extraocular muscle deficits, chorioretinitis, and paraplegia without sensory symptoms. EMG showed severe diffuse denervation, but only mildly slowed nerve conduction velocities, in both legs. Meningitis persisted for 6 weeks and was exacerbated prior to the patient's death. Necropsy revealed subpial and subependymal cytomegalovirus (CMV) infection. Histology of ventral roots demonstrated proximal CMV infection and massive fiber loss. In this immunosuppressed patient, CMV caused a severe motor polyradiculopa-thy by selective destruction of the motor neurons of ventral spinal roots and motor cranial nerves.

Address correspondence and reprint requests to Dr. McCutchan, Division of Infectious Diseases, UCSD Medical Center, San Diego, CA 92103.

Received November 5, 1985. Accepted for publication in final form August 5, 1986.




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