Summary

Neurologic complications of HIV remain common despite the availability of effective ART
HIV-infected patients should be evaluated for possible neurologic symptoms
OIs and primary CNS lymphoma occur almost exclusively in patients with marked immunosuppression
Other disorders, such as HIV-associated distal symmetric polyneuropathy and HIV-associated dementia, occur at any CD4+ cell count

Referral

Patients presenting with suspected neurologic conditions should be referred to a neurologist
Diagnostic testing should focus on the leading differential diagnoses
Common diagnostic studies include neuropsychological testing, neuroimaging, blood tests, CSF examination, electroencephalography, and nerve conduction studies and electromyography

Epidemiology and Clinical Presentation

HAND is the most common CNS complication of HIV, although severe forms are rare
- Presents with slowly progressive cognitive decline, with or without depression, withdrawal, and psychomotor slowing
Parkinsonian symptoms such as decreased facial expression, mildly increased muscle tone, frontal release signs, and mild slowing of gait are common^{[...

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