Dementia Due to HIV Infection (cont.)
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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.
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.
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.
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 is the most accurate method of pinpointing and documenting your cognitive abilities.
Florian P Thomas, MD, MA, PhD
Nestor Galvez-Jimenez, MD
Francisco Talavera, PharmD, PhD
Helmi L Lutsep, MD
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