Dr Jessica Robinson-Papp Discusses Symptoms Indicating Neurological Complications in People With HIV

Jessica Robinson-Papp, MD, MS, professor of neurology at Icahn School of Medicine at Mount Sinai, discusses how neurologic symptoms in individuals with HIV can present in various places in the body while also possibly pointing to a neurologic condition.

Some neurologic symptoms in patients with HIV can be more obvious than others, says Jessica Robinson-Papp, MD, MS, professor of neurology at Icahn School of Medicine at Mount Sinai.


What are some symptoms you look for in patients with HIV who you may suspect have a neurological complication of their HIV?

That can be really broad, and some of the symptoms, I think, are more overt than others. So, for example, in patients who have advanced immunosuppression and AIDS and we're worried about an infection in the brain, some of the symptoms might be things like headache or confusion [or] seizures. If it's an infection, you could have fever and other kinds of systemic signs of infection.

If it is a patient who is not particularly immunosuppressed, and has been doing well, often those neurologic complications are similar to somebody who didn't have HIV. In that case, you’re just basically starting with the symptoms that the patient complains of. Some of the things that I see a lot of are peripheral neuropathies. Those patients will sometimes complain of pain or numbness or tingling in the bottoms of their feet or coming up their legs. That can be a common symptom.

One of the other disorders that we see a lot of are HIV-associated neurocognitive disorders, which is abbreviated HAND, and those patients may report difficulty with different cognitive processes. So, maybe they're having trouble focusing like they used to, or handling their finances or their appointments or managing in their day-to-day life.

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