HIV-ASSOCIATED NEUROCOGNITIVE DISORDER
HIV is a neurotropic virus and invades the CNS early during infection. Meningo-encephalitis may occur at seroconversion. About 50% of HIV-infected people have abnormal neuropsychiatric testing, the proportion increasing with declining CD4 counts. The term HIVassociated neurocognitive disorders (HAND) describes a spectrum of disorders: asymptomatic neurocognitive impairment (which is the most common), minor neurocognitive disorder and HIV-associated dementia (also called HIV encephalopathy). Dementia occurs in late disease and is a subcortical dementia characterized by impairment of executive function, psychomotor retardation and impaired memory. There is no diagnostic test for HIV-associated dementia. CT or magnetic resonance imaging (MRI) shows diffuse cerebral atrophy out of keeping with age. It is important to exclude depression, cryptococcal meningitis and neurosyphilis. ART usually improves HIV-associated dementia, but milder forms of HAND often persist.
Progressive multifocal leucoencephalopathy
Progressive multifocal leucoencephalopathy (PML) is a progressive disease that presents with stroke-like episodes and cognitive impairment. Vision is often impaired due to involvement of the occipital cortex. PML is caused by the JC virus. A combination of characteristic appearances on MRI and detection of JC virus DNA in the cerebrospinal fluid (CSF) by PCR is diagnostic. No specific treatment exists and prognosis remains poor despite ART.
HOMEOPATHIC MANAGEMENT: -
The medicines that can be thought of use are:-
- Baryta carb
- Cannabis indica
- Kali phos