Dear Doc,

Wondering if you could provide me with some information. First let me preface saying that if i've misposted this question to wrong category please feel free to foward it appropriately. That said a slight amount of background I have always suffered from what I had been told was Sinus headaches. The older I became and I guess based upon description of symptoms into adulthood was told it was more likely the headaches suffered were migraines. I was diagnosed with HIV in 2004 with a cd4 in the 170 range and a viral load >750,000 (since those numbers have drastically improved current labs are +500 cd4 and <50 on the VL) however several months ago I had mentioned to my ID these spouts I had been having where for approximately 30-45 seconds up to maybe a minute or so I will first start with a very harsh sense of an odor most often so unpleasant it smells like ammonia (to the point of burning nostrils) other times not as bad yet still very unpleasant, this quickly is followed by and in conjuncition with a very faint feeling I've been know to describe it as almost feeling like having an out of body experience, (maybe a slight dementia not sure it's difficult to describe the feeling). As the unpleasant sense slowly goes away the faintness/outofbody/dementia as decrease and i'm left with a wave of tingling or goosebumps that flow over my body. When mentioned to my ID he had informed me it could be related to the headaches, also please keep in mind that these are brand new symptoms never experienced. This made some sense in the fact the next several episodes I noticed the pressure in head area yet it's almost as if the headache is almost unrecognized when these symptoms are present (it was only after my ID mentioned that I made notes to study it more and discovered the pressure in the head area), here is what has me concerned I recently discussed this with my Neurologist who had posed two questions 1. if there was a history of seizures which the answer is none ever, and secondly asked if an MRI of the brain had ever been done previously and mention the that brain lesions were common amgonst hiv'ers. He ordered an eeg & mri with and without contrast of of the brain. Obviously not much I can do until I get those results (which will be in by next friday 2/15, but is there a greater likely hood that this could be caused by a lesions in the brain and if so and/or not is there any other testing besides the MRI & EEG that you'd recommend to try and figure out what is going on???

Thank you in advance if you should choose this question to be answered and I did try to search the forums the best I could for possible other posts on this subject.

Slightly Concerned

You don't mention which HIV drugs you are taking (this is the side effects of HIV treatment forum). The opportunistic infection forum on The Body is no longer active. A few HIV medications can cause some central nervous system side effects (such as efavirenz). Other HIV medications may not penetrate well into the brain so that there is a concern about a disconnect between doing well in the blood regions (good blood results) and some ongoing brain problems. HIV+ persons can suffer from the same non-AIDS related problems as the general population as well so that migraine headache or some forms of seizures can develop independent of HIV or HIV drugs. A MRI scan of the brain and a good history and physical examination is a good place to start sorting out the possibilities. KH