Guest guest Posted December 5, 2005 Report Share Posted December 5, 2005 I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC KC, Many of the symptoms are familiar to me. I pasted the ones that I can relate to. Sue *slowed thinking, memory impairment, forgetfulness and difficulty concentrating. *complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them *managing their financial affairs or shopping - This is interesting because I was forgetting to write checks, when I did I sometimes forgot to sign them & once I sent the car loan check to Mastercard. Shopping was a nightmare, if I didn't have EVERYTHING written down I just couldn't remember!! *disorientation, confusion and agitation *hand tremor,decreased balance, weakness in their upper and lower extremities - I felt weak all over but my legs at times felt like they wouldn't support me much longer! * sleep disturbances, fatigue, headaches and decreased libido. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 Yes many of the symptoms hit the nail on the head. I thought I was just losing my marbles. -- Re: [] HIV and the Brain I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC KC, Many of the symptoms are familiar to me. I pasted the ones that I can relate to. Sue *slowed thinking, memory impairment, forgetfulness and difficulty concentrating. *complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them *managing their financial affairs or shopping - This is interesting because I was forgetting to write checks, when I did I sometimes forgot to sign them & once I sent the car loan check to Mastercard. Shopping was a nightmare, if I didn't have EVERYTHING written down I just couldn't remember!! *disorientation, confusion and agitation *hand tremor,decreased balance, weakness in their upper and lower extremities - I felt weak all over but my legs at times felt like they wouldn't support me much longer! * sleep disturbances, fatigue, headaches and decreased libido. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 I second it. Also the fact that every day I leave one room go to the other to get or do something & as soon as I get just to the other room (30 seconds) I forget what I was going to get or do. I do this pretty consistantly & it drives me nuts. Then I go back to the original room to hopefully remember. Sometimes I do, sometimes I don't! Plus I'll call my husband. I don't get him but he'll call me back & I don't remember what I called him about. That's almost every day too. Yi Yi Yi! I need a new brain. Thanks for sharing! Loni <parkekaa@...> wrote: Yes many of the symptoms hit the nail on the head. I thought I was just losing my marbles. -- Re: [] HIV and the Brain I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC KC, Many of the symptoms are familiar to me. I pasted the ones that I can relate to. Sue *slowed thinking, memory impairment, forgetfulness and difficulty concentrating. *complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them *managing their financial affairs or shopping - This is interesting because I was forgetting to write checks, when I did I sometimes forgot to sign them & once I sent the car loan check to Mastercard. Shopping was a nightmare, if I didn't have EVERYTHING written down I just couldn't remember!! *disorientation, confusion and agitation *hand tremor,decreased balance, weakness in their upper and lower extremities - I felt weak all over but my legs at times felt like they wouldn't support me much longer! * sleep disturbances, fatigue, headaches and decreased libido. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 Milk in the cupboard and sugar in the fridge, does this sound famila?. Getting halfway down the hall and forget what you're going for? I forget my own name and ph# at times. Brain fog! SW -- Re: [] HIV and the Brain I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC KC, Many of the symptoms are familiar to me. I pasted the ones that I can relate to. Sue *slowed thinking, memory impairment, forgetfulness and difficulty concentrating. *complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them *managing their financial affairs or shopping - This is interesting because I was forgetting to write checks, when I did I sometimes forgot to sign them & once I sent the car loan check to Mastercard. Shopping was a nightmare, if I didn't have EVERYTHING written down I just couldn't remember!! *disorientation, confusion and agitation *hand tremor,decreased balance, weakness in their upper and lower extremities - I felt weak all over but my legs at times felt like they wouldn't support me much longer! * sleep disturbances, fatigue, headaches and decreased libido. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 Yes, amazing how every symptom of ill health for the past 14 years has magically begun to fade away > > I wish I could get a show of hands from everyone on this board > concerning the symptoms they mention here. How many of you can > relate to what they are speaking of? Just a thought. > > KC > > > Psychiatric Manifestations of HIV Infection and AIDS > By Ewald Horwath, M.D., and Sara Siris Nash, M.D. > Psychiatric Times November 2005 Vol. XXIII Issue 13 > > Human immunodeficiency virus (HIV) > > > HIV and the Brain > > Follow the link for full story. > http://www.psychiatrictimes.com/showArticle.jhtml? articleId=174402642 > > > Shortly after the initial HIV infection, the virus enters the > central nervous system and may cause meningitis or encephalitis. > Other serious CNS complications tend to occur late in the course of > disease, when immune function has significantly declined, though > studies have reported conflicting results as to the predictive value > of CD4 counts in assessing cognitive and motor performance > (Bornstein et al., 1991; Goethe et al., 1989; Koralnik et al., 1990; > McArthur et al., 1989; et al., 1990; Saykin et al., 1988). > Viral load is more closely associated with the degree of cognitive > impairment. Patients with serum viral loads ¡Ý30,000 copies/mL are > 8.5 times more likely to develop dementia compared to patients with > viral loads <3,000 copies/mL (Childs et al., 1999). In another > study, a cerebrospinal fluid viral load >200 copies/mL was > predictive of progression to neuropsychological impairment (Ellis et > al., 2002). > > > HIV-Associated Dementia > > > Patients infected with HIV are at risk of developing dementia as a > direct result of viral infection. This syndrome has been referred to > by various names: HIV-associated dementia complex (HAD) (Working > Group of the American Academy of Neurology AIDS Task Force, 1991), > HIV encephalopathy, subacute encephalitis (Snider et al., 1983), > AIDS encephalopathy and AIDS-dementia complex (Navia et al., 1986b). > HIV-associated dementia is defined as acquired cognitive > abnormalities in two or more domains and is associated with > functional impairment and acquired motor or behavioral > abnormalities, in the absence of another etiology (Table 1). > > > The clinical manifestations of HAD are predominantly those of > subcortical dementia, with some similarity to those found in > dementia associated with Huntington's disease and Parkinson's > disease. Neuropathological evidence demonstrates that HIV-related > diseases in the CNS are preferentially located in certain > subcortical structures of the brain (e.g., white matter, basal > ganglia and hippocampus) as well as in the spinal cord (Cummings, > 1990; Navia et al., 1986a). Consistent with the subcortical nature > of the dementing process, patients with HAD typically have > disturbances in three neuropsychiatric spheres of functioning: > cognitive, motor and behavioral. > > > The cognitive disturbance usually has a subtle onset and involves > slowed thinking, memory impairment, forgetfulness and difficulty > concentrating. Patients often complain that normal activities take > longer or that they have to repeatedly reread paragraphs of text in > order to understand them. As the dementia progresses, gross > cognitive disturbances often occur, and patients begin to experience > greater difficulty managing their financial affairs or shopping and > caring for themselves. > > > disorientation, confusion and muteness are observed late in > the illness. Psychiatric symptoms, such as agitation, mania, > hallucinations and paranoid delusions, are also not unusual in > advanced disease stages. The management of these psychiatric > disturbances needs to take into account the greater sensitivity to > the extrapyramidal side effects of antipsychotic medications seen in > patients with HIV infection (, 1990). For this reason atypical > antipsychotics with a low risk of EPS, such as quetiapine (Seroquel) > and aripiprazole (Abilify), may be preferable in this population. > > > The motor disturbance begins with subtle signs such as slowed > movements or hand tremor. Other common symptoms include decreased > balance, lack of coordination, difficulty with rapid alternating > movements, abnormal eye movements (including saccades and pursuit) > and a sense of general clumsiness. For patients afflicted with > vacuolar myelopathy or spinal cord involvement from HIV, motor signs > include gait difficulty or bumping into things. When sitting, they > may find themselves unexpectedly leaning or falling to one side in > the absence of adequate postural support. > > > As the impairment progresses, patients experience weakness in their > upper and lower extremities. In late stages of disease, paraplegia > and urinary and bowel incontinence occur. When motor signs and > symptoms occur in the absence of HIV dementia, the syndrome is known > as HIV-associated myelopathy. > > > Behavioral symptoms include social withdrawal, apathy, sleep > disturbances, fatigue, headaches and decreased libido. These > features may be difficult to distinguish from depressive symptoms, > though the patient often lacks the dysphoria experienced in a > clinical major depression. (1990) has commented that the > apathy, withdrawal and mental slowing found in HAD can be > differentiated clinically from low self-esteem, irrational guilt and > other features characteristic of depression. Nonetheless, these > symptoms are important to recognize and should not be dismissed > simply as emotional responses to the diagnosis of HIV infection. A > less severe form of CNS disease associated with HIV infection is HIV- > associated minor cognitive-motor disturbance, which is > differentiated from HAD based upon the presence of fewer symptoms > and little or no functional impairment (Table 1). > > > Opportunistic Infections > > > Infection with HIV may indirectly lead to neuropsychiatric > disturbances due to CNS opportunistic infections, neoplasms and > metabolic disorders (Table 2). These infections are unusual in the > absence of HIV and tend to occur late in the course of illness, when > immune function is waning, CD4+ cell counts fall to very low levels > and viral load is rising. With the widespread use of highly active > antiretroviral therapy (HAART), the incidence of opportunistic > infections and other complications of HIV infection have fallen > dramatically. The identification of the underlying cause of > neuropsychiatric disturbance in an individual infected with HIV is > very important because some of these conditions are responsive to > treatment, and delayed diagnosis and treatment may result in > permanent CNS damage. > > > The most common CNS opportunistic infections are cerebral > toxoplasmosis, cryptococcal meningitis and progressive multifocal > leukoencephalopathy. Less common CNS opportunistic infections > include meningitis caused by Mycobacterium tuberculosis and other > fungal CNS infections, such as candidiasis, coccidioidomycosis, > aspergillosis and histoplasmosis. Opportunistic viral infections > involving the CNS include cytomegalovirus, herpes simplex virus and > varicella-zoster virus. Acute mental status changes can also occur > as a result of metabolic disturbances, such as hypoxia, fever, > dehydration, electrolyte disturbances, uremia and hepatic > encephalopathy. > > > Central nervous system involvement also occurs as a result of > primary CNS lymphoma, which tends to occur late in the course of HIV > infection. Central nervous system manifestations of metastatic > systemic lymphoma and Kaposi's sarcoma have been reported in > patients with AIDS, but are uncommon. > > > Finally, many antibacterial, antifungal, antineoplastic and > antiviral medications, in addition to the antiretroviral therapies, > have CNS side effects. An awareness of the types of pharmacological > treatments used and their potential side effects is important in the > evaluation of psychiatric symptoms in patients who are HIV positive. > Some of the drugs more commonly used in HIV and their > neuropsychiatric side effects are listed in Table 3. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 During most of my doctor's visits all the doctors brought up HIV/Aids. It appears that a lot of my symptoms were the same. They did a lot of blood tests to rule HIV/AIDS out. But they still brought it up? Curious isn't it? SW > I wish I could get a show of hands from everyone on this board > concerning the symptoms they mention here. How many of you can > relate to what they are speaking of? Just a thought. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 I've had about 80% of the symptoms mentioned here and then some. Just don't have the ones that kill you yet. I am HIV negative, but was tested a few years ago because of symptoms. Kathy tigerpaw2c <tigerpaw2c@...> wrote: I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC Psychiatric Manifestations of HIV Infection and AIDS By Ewald Horwath, M.D., and Sara Siris Nash, M.D. Psychiatric Times November 2005 Vol. XXIII Issue 13 Human immunodeficiency virus (HIV) HIV and the Brain Follow the link for full story. http://www.psychiatrictimes.com/showArticle.jhtml?articleId=174402642 Shortly after the initial HIV infection, the virus enters the central nervous system and may cause meningitis or encephalitis. Other serious CNS complications tend to occur late in the course of disease, when immune function has significantly declined, though studies have reported conflicting results as to the predictive value of CD4 counts in assessing cognitive and motor performance (Bornstein et al., 1991; Goethe et al., 1989; Koralnik et al., 1990; McArthur et al., 1989; et al., 1990; Saykin et al., 1988). Viral load is more closely associated with the degree of cognitive impairment. Patients with serum viral loads ¡Ý30,000 copies/mL are 8.5 times more likely to develop dementia compared to patients with viral loads <3,000 copies/mL (Childs et al., 1999). In another study, a cerebrospinal fluid viral load >200 copies/mL was predictive of progression to neuropsychological impairment (Ellis et al., 2002). HIV-Associated Dementia Patients infected with HIV are at risk of developing dementia as a direct result of viral infection. This syndrome has been referred to by various names: HIV-associated dementia complex (HAD) (Working Group of the American Academy of Neurology AIDS Task Force, 1991), HIV encephalopathy, subacute encephalitis (Snider et al., 1983), AIDS encephalopathy and AIDS-dementia complex (Navia et al., 1986b). HIV-associated dementia is defined as acquired cognitive abnormalities in two or more domains and is associated with functional impairment and acquired motor or behavioral abnormalities, in the absence of another etiology (Table 1). The clinical manifestations of HAD are predominantly those of subcortical dementia, with some similarity to those found in dementia associated with Huntington's disease and Parkinson's disease. Neuropathological evidence demonstrates that HIV-related diseases in the CNS are preferentially located in certain subcortical structures of the brain (e.g., white matter, basal ganglia and hippocampus) as well as in the spinal cord (Cummings, 1990; Navia et al., 1986a). Consistent with the subcortical nature of the dementing process, patients with HAD typically have disturbances in three neuropsychiatric spheres of functioning: cognitive, motor and behavioral. The cognitive disturbance usually has a subtle onset and involves slowed thinking, memory impairment, forgetfulness and difficulty concentrating. Patients often complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them. As the dementia progresses, gross cognitive disturbances often occur, and patients begin to experience greater difficulty managing their financial affairs or shopping and caring for themselves. disorientation, confusion and muteness are observed late in the illness. Psychiatric symptoms, such as agitation, mania, hallucinations and paranoid delusions, are also not unusual in advanced disease stages. The management of these psychiatric disturbances needs to take into account the greater sensitivity to the extrapyramidal side effects of antipsychotic medications seen in patients with HIV infection (, 1990). For this reason atypical antipsychotics with a low risk of EPS, such as quetiapine (Seroquel) and aripiprazole (Abilify), may be preferable in this population. The motor disturbance begins with subtle signs such as slowed movements or hand tremor. Other common symptoms include decreased balance, lack of coordination, difficulty with rapid alternating movements, abnormal eye movements (including saccades and pursuit) and a sense of general clumsiness. For patients afflicted with vacuolar myelopathy or spinal cord involvement from HIV, motor signs include gait difficulty or bumping into things. When sitting, they may find themselves unexpectedly leaning or falling to one side in the absence of adequate postural support. As the impairment progresses, patients experience weakness in their upper and lower extremities. In late stages of disease, paraplegia and urinary and bowel incontinence occur. When motor signs and symptoms occur in the absence of HIV dementia, the syndrome is known as HIV-associated myelopathy. Behavioral symptoms include social withdrawal, apathy, sleep disturbances, fatigue, headaches and decreased libido. These features may be difficult to distinguish from depressive symptoms, though the patient often lacks the dysphoria experienced in a clinical major depression. (1990) has commented that the apathy, withdrawal and mental slowing found in HAD can be differentiated clinically from low self-esteem, irrational guilt and other features characteristic of depression. Nonetheless, these symptoms are important to recognize and should not be dismissed simply as emotional responses to the diagnosis of HIV infection. A less severe form of CNS disease associated with HIV infection is HIV- associated minor cognitive-motor disturbance, which is differentiated from HAD based upon the presence of fewer symptoms and little or no functional impairment (Table 1). Opportunistic Infections Infection with HIV may indirectly lead to neuropsychiatric disturbances due to CNS opportunistic infections, neoplasms and metabolic disorders (Table 2). These infections are unusual in the absence of HIV and tend to occur late in the course of illness, when immune function is waning, CD4+ cell counts fall to very low levels and viral load is rising. With the widespread use of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections and other complications of HIV infection have fallen dramatically. The identification of the underlying cause of neuropsychiatric disturbance in an individual infected with HIV is very important because some of these conditions are responsive to treatment, and delayed diagnosis and treatment may result in permanent CNS damage. The most common CNS opportunistic infections are cerebral toxoplasmosis, cryptococcal meningitis and progressive multifocal leukoencephalopathy. Less common CNS opportunistic infections include meningitis caused by Mycobacterium tuberculosis and other fungal CNS infections, such as candidiasis, coccidioidomycosis, aspergillosis and histoplasmosis. Opportunistic viral infections involving the CNS include cytomegalovirus, herpes simplex virus and varicella-zoster virus. Acute mental status changes can also occur as a result of metabolic disturbances, such as hypoxia, fever, dehydration, electrolyte disturbances, uremia and hepatic encephalopathy. Central nervous system involvement also occurs as a result of primary CNS lymphoma, which tends to occur late in the course of HIV infection. Central nervous system manifestations of metastatic systemic lymphoma and Kaposi's sarcoma have been reported in patients with AIDS, but are uncommon. Finally, many antibacterial, antifungal, antineoplastic and antiviral medications, in addition to the antiretroviral therapies, have CNS side effects. An awareness of the types of pharmacological treatments used and their potential side effects is important in the evaluation of psychiatric symptoms in patients who are HIV positive. Some of the drugs more commonly used in HIV and their neuropsychiatric side effects are listed in Table 3. FAIR USE NOTICE: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2005 Report Share Posted December 6, 2005 From: Kathy Sent: Tuesday, December 06, 2005 6:47 AM Subject: Re: [] HIV and the Brain I've had about 80% of the symptoms mentioned here and then some. * So mold and HIV have similar effects on the brain. What about the mechanisms? Are there any similarities there? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2005 Report Share Posted December 7, 2005 Ok- check below for my symptoms. > > I wish I could get a show of hands from everyone on this board > concerning the symptoms they mention here. How many of you can > relate to what they are speaking of? Just a thought. > > KC > > > Psychiatric Manifestations of HIV Infection and AIDS > By Ewald Horwath, M.D., and Sara Siris Nash, M.D. > Psychiatric Times November 2005 Vol. XXIII Issue 13 > > HIV and the Brain > > HIV-Associated Dementia > > 1990; Navia et al., 1986a). Consistent with the subcortical nature > of the dementing process, patients with HAD typically have > disturbances in three neuropsychiatric spheres of functioning: > cognitive, motor and behavioral. > > > The cognitive disturbance usually has a subtle onset and involves > slowed thinking, memory impairment, forgetfulness and difficulty > concentrating. Patients often complain that normal activities take > longer or that they have to repeatedly reread paragraphs of text in > order to understand them. As the dementia progresses, gross > cognitive disturbances often occur, and patients begin to experience > greater difficulty managing their financial affairs or shopping and > caring for themselves. Cognitive: I have had all of these Motor: tremor, decreased balance, difficulty reading, general weakness Behavioral: fatigue, social withdrawal, apathy, anxiety, depression Opportunistic Infections: (HA) fungal, of course, and herpes virus > Infection with HIV may indirectly lead to neuropsychiatric > disturbances due to CNS opportunistic infections, neoplasms and > metabolic disorders (Table 2). These infections are unusual in the > absence of HIV and tend to occur late in the course of illness, when > immune function is waning, CD4+ cell counts fall to very low levels > and viral load is rising. This is just so silly to say that this is unusual in the absense of hiv- there are blinders on the medical community in my opinion. If the doctors refuse to see these symptoms and call it hypochondriatism, how can anyone be helped by that? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2005 Report Share Posted December 9, 2005 I was tested for HIV also and it was negative. I had so many other test also and they were all negative. I have most of the symtoms they listed including a low Immune System. I have the IVIG treatments and there are other people there with HIV having the same treatments. Only difference is I don't take the HIV drugs. Marcie Kathy <kathywnb@...> wrote: I've had about 80% of the symptoms mentioned here and then some. Just don't have the ones that kill you yet. I am HIV negative, but was tested a few years ago because of symptoms. Kathy tigerpaw2c <tigerpaw2c@...> wrote: I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC Psychiatric Manifestations of HIV Infection and AIDS By Ewald Horwath, M.D., and Sara Siris Nash, M.D. Psychiatric Times November 2005 Vol. XXIII Issue 13 Human immunodeficiency virus (HIV) HIV and the Brain Follow the link for full story. http://www.psychiatrictimes.com/showArticle.jhtml?articleId=174402642 Shortly after the initial HIV infection, the virus enters the central nervous system and may cause meningitis or encephalitis. Other serious CNS complications tend to occur late in the course of disease, when immune function has significantly declined, though studies have reported conflicting results as to the predictive value of CD4 counts in assessing cognitive and motor performance (Bornstein et al., 1991; Goethe et al., 1989; Koralnik et al., 1990; McArthur et al., 1989; et al., 1990; Saykin et al., 1988). Viral load is more closely associated with the degree of cognitive impairment. Patients with serum viral loads ¡Ý30,000 copies/mL are 8.5 times more likely to develop dementia compared to patients with viral loads <3,000 copies/mL (Childs et al., 1999). In another study, a cerebrospinal fluid viral load >200 copies/mL was predictive of progression to neuropsychological impairment (Ellis et al., 2002). HIV-Associated Dementia Patients infected with HIV are at risk of developing dementia as a direct result of viral infection. This syndrome has been referred to by various names: HIV-associated dementia complex (HAD) (Working Group of the American Academy of Neurology AIDS Task Force, 1991), HIV encephalopathy, subacute encephalitis (Snider et al., 1983), AIDS encephalopathy and AIDS-dementia complex (Navia et al., 1986b). HIV-associated dementia is defined as acquired cognitive abnormalities in two or more domains and is associated with functional impairment and acquired motor or behavioral abnormalities, in the absence of another etiology (Table 1). The clinical manifestations of HAD are predominantly those of subcortical dementia, with some similarity to those found in dementia associated with Huntington's disease and Parkinson's disease. Neuropathological evidence demonstrates that HIV-related diseases in the CNS are preferentially located in certain subcortical structures of the brain (e.g., white matter, basal ganglia and hippocampus) as well as in the spinal cord (Cummings, 1990; Navia et al., 1986a). Consistent with the subcortical nature of the dementing process, patients with HAD typically have disturbances in three neuropsychiatric spheres of functioning: cognitive, motor and behavioral. The cognitive disturbance usually has a subtle onset and involves slowed thinking, memory impairment, forgetfulness and difficulty concentrating. Patients often complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them. As the dementia progresses, gross cognitive disturbances often occur, and patients begin to experience greater difficulty managing their financial affairs or shopping and caring for themselves. disorientation, confusion and muteness are observed late in the illness. Psychiatric symptoms, such as agitation, mania, hallucinations and paranoid delusions, are also not unusual in advanced disease stages. The management of these psychiatric disturbances needs to take into account the greater sensitivity to the extrapyramidal side effects of antipsychotic medications seen in patients with HIV infection (, 1990). For this reason atypical antipsychotics with a low risk of EPS, such as quetiapine (Seroquel) and aripiprazole (Abilify), may be preferable in this population. The motor disturbance begins with subtle signs such as slowed movements or hand tremor. Other common symptoms include decreased balance, lack of coordination, difficulty with rapid alternating movements, abnormal eye movements (including saccades and pursuit) and a sense of general clumsiness. For patients afflicted with vacuolar myelopathy or spinal cord involvement from HIV, motor signs include gait difficulty or bumping into things. When sitting, they may find themselves unexpectedly leaning or falling to one side in the absence of adequate postural support. As the impairment progresses, patients experience weakness in their upper and lower extremities. In late stages of disease, paraplegia and urinary and bowel incontinence occur. When motor signs and symptoms occur in the absence of HIV dementia, the syndrome is known as HIV-associated myelopathy. Behavioral symptoms include social withdrawal, apathy, sleep disturbances, fatigue, headaches and decreased libido. These features may be difficult to distinguish from depressive symptoms, though the patient often lacks the dysphoria experienced in a clinical major depression. (1990) has commented that the apathy, withdrawal and mental slowing found in HAD can be differentiated clinically from low self-esteem, irrational guilt and other features characteristic of depression. Nonetheless, these symptoms are important to recognize and should not be dismissed simply as emotional responses to the diagnosis of HIV infection. A less severe form of CNS disease associated with HIV infection is HIV- associated minor cognitive-motor disturbance, which is differentiated from HAD based upon the presence of fewer symptoms and little or no functional impairment (Table 1). Opportunistic Infections Infection with HIV may indirectly lead to neuropsychiatric disturbances due to CNS opportunistic infections, neoplasms and metabolic disorders (Table 2). These infections are unusual in the absence of HIV and tend to occur late in the course of illness, when immune function is waning, CD4+ cell counts fall to very low levels and viral load is rising. With the widespread use of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections and other complications of HIV infection have fallen dramatically. The identification of the underlying cause of neuropsychiatric disturbance in an individual infected with HIV is very important because some of these conditions are responsive to treatment, and delayed diagnosis and treatment may result in permanent CNS damage. The most common CNS opportunistic infections are cerebral toxoplasmosis, cryptococcal meningitis and progressive multifocal leukoencephalopathy. Less common CNS opportunistic infections include meningitis caused by Mycobacterium tuberculosis and other fungal CNS infections, such as candidiasis, coccidioidomycosis, aspergillosis and histoplasmosis. Opportunistic viral infections involving the CNS include cytomegalovirus, herpes simplex virus and varicella-zoster virus. Acute mental status changes can also occur as a result of metabolic disturbances, such as hypoxia, fever, dehydration, electrolyte disturbances, uremia and hepatic encephalopathy. Central nervous system involvement also occurs as a result of primary CNS lymphoma, which tends to occur late in the course of HIV infection. Central nervous system manifestations of metastatic systemic lymphoma and Kaposi's sarcoma have been reported in patients with AIDS, but are uncommon. Finally, many antibacterial, antifungal, antineoplastic and antiviral medications, in addition to the antiretroviral therapies, have CNS side effects. An awareness of the types of pharmacological treatments used and their potential side effects is important in the evaluation of psychiatric symptoms in patients who are HIV positive. Some of the drugs more commonly used in HIV and their neuropsychiatric side effects are listed in Table 3. FAIR USE NOTICE: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2005 Report Share Posted December 9, 2005 Thank goodness for Drivers License...I check mine often to make sure what my name is!!! LOL! Marcie Sheehan <msheeh02@...> wrote: Milk in the cupboard and sugar in the fridge, does this sound famila?. Getting halfway down the hall and forget what you're going for? I forget my own name and ph# at times. Brain fog! SW -- Re: [] HIV and the Brain I wish I could get a show of hands from everyone on this board concerning the symptoms they mention here. How many of you can relate to what they are speaking of? Just a thought. KC KC, Many of the symptoms are familiar to me. I pasted the ones that I can relate to. Sue *slowed thinking, memory impairment, forgetfulness and difficulty concentrating. *complain that normal activities take longer or that they have to repeatedly reread paragraphs of text in order to understand them *managing their financial affairs or shopping - This is interesting because I was forgetting to write checks, when I did I sometimes forgot to sign them & once I sent the car loan check to Mastercard. Shopping was a nightmare, if I didn't have EVERYTHING written down I just couldn't remember!! *disorientation, confusion and agitation *hand tremor,decreased balance, weakness in their upper and lower extremities - I felt weak all over but my legs at times felt like they wouldn't support me much longer! * sleep disturbances, fatigue, headaches and decreased libido. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2005 Report Share Posted December 10, 2005 It seems to me that the kinds of changes in the brain seen in these diseases (including mold) may be due to the brain not being able to create new connections between neurons, which are essential for the long-term storage of memories, for example. For mycotoxins such as the trichothecene mycotoxins, which are cytotoxic, (meaning they kill cells directly when they come into contact, and also kill new cells being formed in the body, not unlike the poisons that are used for cancer chemotherapy..) this model would make sense.. Of course, there are so many different mold organisms and they grow on so many different substrates under so many conditions that you can't really generalize about them that much. But when you look at environmental toxins in general, they fall into broad classifications based on their effects.. Actually, you could say the same thing for all biologically active compounds. Of course, the mycotoxins are so numerous that they have members in all of the different groups of biologically active compounds.. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2005 Report Share Posted December 10, 2005 Another thing that many toxins do is create reactive oxygen species, 'free radicals', as they are known.. From what we know about aging, ROS are responsible for quite a few of agings effects.. So toxins that produce them basically age you on a cellular level. Certainly, aging is part of life. Perhaps one of the reasons we age is because we are exposed to toxic substances in our environment at differing rates. So, being in a home with lots of mycotoxins might age you very rapidly, compared to living in a healthy place without them. To counteract that one would be well advised to take higher than average doses of 'antioxidants' But if you have poisons in your environment, they will do bad things to you, nomatter how smart you are at trying to prevent this. But the antioxidants might make the difference between getting cancer and not, or between going blind or getting MS and not.. at least within your lifespan.. Quote Link to comment Share on other sites More sharing options...
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