Infect Chemother.  2010 Feb;42(1):57-60. 10.3947/ic.2010.42.1.57.

A Case of Acute Human Immunodeficiency Virus Syndrome Manifesting as Seizure

• Ahn BM
• Lee KM
• Na DK
• Shin YH
• Jung SW
• Lee J

• KMID: 2170283
• DOI: http://doi.org/10.3947/ic.2010.42.1.57

Abstract

Acute human immunodeficiency virus (HIV) syndrome is defined as transient symptomatic illness associated with high-titer HIV replication and an expansive immunologic response to the invading pathogen. Seizure and epilepsy are not rare among the HIV-infected patients. Major causes of HIV-related seizure are focal brain lesion, meningitis, metabolic derangement, and no identified causes other than HIV itself. Generally, seizure in HIV infected patients develops during the advanced stages of the disease; decreased immunity and increased chances of developing opportunistic infection in the central nervous system (CNS) predispose them to have seizures attacks. We report a case of acute HIV syndrome which presented as new-onset seizure. Since no evidence of focal brain lesion or any opportunistic infection could be found, the most probable cause of seizure could be attributed to acute HIV syndrome. The patient got better after taking anti-epileptic drug and there have been no further recurrence of episodes so far.

Keyword

Seizure; Acute HIV syndrome

MeSH Terms

Brain
Central Nervous System
Epilepsy
HIV
Humans
Meningitis
Opportunistic Infections
Recurrence
Seizures

Figure

• 

  Figure 1 The axial (A) and sagittal (B) sections of gadolinum enhanced T1-weighted MRI show increased leptomeningeal enhancement.

Reference

1. Lim YH, Chang SJ, Won YW, Hong SM, Cheon SM, Shin JH, Pai HJ. Two cases of acute human immunodeficiency virus syndrome presenting as an acute febrile disease. Korean J Med. 2005. 69:451–456.

2. Jeong JH, Cheun JY, Kim JD, Lee JH, Won HK, Park JH, Kim YK. Acute human immunodeficiency virus infection managed with highly active antiretroviral therapy. Korean J Med. 2009. 76:769–772.

3. Zetola NM, Pilcher CD. Diagnosis and management of acute HIV infection. Infect Dis Clin North Am. 2007. 21:19–48.

4. Kellinghaus C, Engbring C, Kovac S, Möddel G, Boesebeck F, Fischera M, Anneken K, Klönne K, Reichelt D, Evers S, Husstedt IW. Frequency of seizures and epilepsy in neurological HIV-infected patients. Seizure. 2008. 17:27–33.

5. Modi M, Mochan A, Modi G. New onset seizures in HIV-seizure semiology, CD4 counts, and viral loads. Epilepsia. 2009. 50:1266–1269.

6. Bolokadze N, Gabunia P, Ezugbaia M, Gatserelia L, Khechiashvili G. Neurological complications in patients with orgHIV/AIDS. Georgian Med News. 2008. 165:34–38.

7. Satishchandra P, Sinha S. Seizures in HIV-seropositive individuals: NIMHANS experience and review. Epilepsia. 2008. 49:Suppl 6. 33–41.

8. Kahn JO, Walker BD. Acute human immunodeficiency virus type 1 infection. N Engl J Med. 1998. 339:33–39.

9. Tebourski F, Slim A, Elgaaied A. The significance of combining World Health Organization and Center for Disease Control criteria to resolve indeterminate human immunodeficiency virus type-1 Western blot results. Diagn Microbiol Infect Dis. 2004. 48:59–61.

10. Busch MP, Lee LL, Satten GA, Henrard DR, Farzadegan H, Nelson KE, Read S, Dodd RY, Petersen LR. Time course of detection of viral and serologic markers preceding human immunodeficiency virus type 1 seroconversion: implications for screening of blood and tissue donors. Transfusion. 1995. 35:91–97.

11. Li CM, Lee YY, Ho YR. Acute meningoencephalitis as initial presentation of human immunodeficiency virus infection: report of two cases. J Microbiol Immunol Infect. 2002. 35:195–198.

12. Cho CB, Lim TK, Kim JH, Kim SJ, Kim YJ, Choi SR, Lee SS. A case of acute human immunodeficiency virus syndrome presenting as aseptic meningitis. Korean J Med. 2009. 77:Suppl 1. S217–S220.

13. Bhigjee AI. Seizures in HIV/AIDS: a southern African perspective. Acta Neurol Scand Suppl . 2005. 181:4–7.

14. Power C, Boissé L, Rourke S, Gill MJ. NeuroAIDS: an evolving epidemic. Can J Neurol Sci. 2009. 36:285–295.

15. Lee KC, Garcia PA, Alldredge BK. Clinical features of status epilepticus in patients with HIV infection. Neurology. 2005. 65:314–316.