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Dementia Due to HIV Infection (cont.)

Exams and Tests

In a person known to have HIV infection, the appearance of cognitive, behavioral, or motor symptoms suggests that the person has AIDS dementia complex. It is important to consider, however, other possible causes of these symptoms, such as metabolic disorders, infections, degenerative brain diseases, stroke, tumor, and many others. Your health care provider will carry out an evaluation to determine the cause of your symptoms. This will include a medical interview, physical and mental status examinations, CT and/or MRI scans, neuropsychological testing, and, possibly, a spinal tap.
 
Imaging studies

CT scan and MRI can detect changes in the brain that support the diagnosis of AIDS dementia complex. Brain changes in ADC worsen over time, so these studies may be repeated periodically. Importantly, these scans help rule out other treatable conditions such as infection, stroke, and brain tumor.

  • CT scan or MRI of the head: These scans give a detailed, 3-dimensional picture of the brain. They can show brain atrophy (shrinkage) that is consistent with ADC as well as changes in the appearance of different parts of the brain.

  • Position emission tomography (PET) or single-photon emission computed tomography (SPECT) scan: These scans may reveal abnormalities in metabolism in the brain that are consistent with ADC or other conditions. These scans are not yet widely used and are available only at large medical centers.

Lab tests

No lab test confirms the diagnosis of AIDS dementia complex. If you have lab tests, they serve to rule out conditions that might cause similar symptoms. You may have blood drawn for multiple tests.
 
Your health care provider may test your cerebrospinal fluid (CSF). This clear fluid is made in normal cavities in the brain called ventricles (which are seen on CT scan and MRI). The fluid surrounds the brain and spinal cord. It cushions and protects these structures and may distribute beneficial and harmful substances. CSF can be tested for various abnormalities that are related to dementia symptoms. A sample of the CSF is obtained via lumbar puncture (spinal tap). This procedure involves removal of a sample of CSF from the spinal canal in the lower back.
 
Electroencephalography

For electroencephalography (EEG), a series of electrodes are attached to the scalp. The electrical activity of the brain is read and recorded. In the later stages of ADC, the electrical activity (which appears as waves) is slower than normal. EEG also is used to see whether a person is having seizures.

Neuropsychological testing

Neuropsychological testing is the most accurate method of pinpointing and documenting your cognitive abilities.

  • This can help give a more accurate picture of the problems and thus can help in treatment planning. It might be repeated later to monitor changes in symptoms.

  • The testing involves answering questions and performing tasks that have been carefully prepared for this purpose. The test is given by a neurologist, psychologist, or other specially trained professional.

  • It addresses your appearance, mood, anxiety level, and experience of delusions or hallucinations.

  • It assesses cognitive abilities such as memory, attention, orientation to time and place, use of language, and abilities to carry out various tasks and follow instructions.

  • Reasoning, abstract thinking, and problem solving also are tested.

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