Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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Do I have AIDS Dementia?
Jun 26, 2007
In January of 2005 my primary care physician wrote the Board of Medical Examiners of the State of Arizona a letter expressing his concern that I might be suffering from Aids Dementia. They immediately had me turn in my license to practice medicine and then did an MRI scan and neuropsychological testing to support their decision. The results of the neuropsychological testing they refused to show me and the results of the MRI apparently showed some white matter damage. The actual results they refused to show me as well. I was ill at the time of those evaluations as I had been HIV + for almost 20 years and had not been on any medications for HIV during that time. At that time I was started on a HAART regimen and within 3 monhs my viral load had dropped to undetectable and my T-cell count began to rise. I have been compliant with my medication regimen since then and remain viral load undetectable.
Regarding my mental status, when my doctor first wrote the board I was having difficulty driving, getting lost in familiar areas primarily at night. To my knowledge I had made no errors in diagnosing or treating my patients and no complaints were received by myself, my staff or the Medical Board regarding my practice of medicine. Several months ago I saw a neurologist who specializes in AIDS related dementia who ordered a PET scan. The results showed no evidence of any type of dementia. Neither I nor any of my family or acquaintences have noted any symptoms of dementia. My question for you is is there any other diagnostic tests or evaluations you might suggest I take before requesting the restrictions on my license be lifted.
-John
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Response from Dr. Horwath
Neuropsychological testing is the most precise way to assess your cognitive capacity. A neurological exam would assess whether you have any of the motor signs or symptoms, such as hand tremor, gait problems, arm or leg weakness.
There are no lab tests, including brain imaging studies that are diagnostic.
Most importantly, a diagnosis of HIV-associated dementia requires that you have cognitive, motor and/or psychological symptoms and that these symptoms cause you significant impairment in your ability to work or socially interact. If you're able to function normally, then you cannot be properly diagnosed with dementia.
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