Myelopathy and HIV infection.

The clinical significance of myelopathy associated with HIV infection is poorly understood. Recently, a prospective electrophysiological follow-up study of spinal-evoked potentials in HIV-seropositive men without AIDS revealed a 32% prolongation of the latency from the gluteal crease to the 12th thoracic vertebra (T12) following tibial nerve stimulation at the ankle performed after an interval of 2 years. In AIDS patients this transmission delay did not increase further. Instead, the latency prolongation took place proximal to T12. We assume that myelopathy is an integral part of HIV infection that it is asymptomatic in the early disease phase, spreads from the lumbar part the spinal cord in a rostral direction and leads to the development of leg weakness and ataxia during the later stages of the disease.