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Neuropathy?Seizures?
Dec 8, 1997

Dr. Gallant,

I have been following your medium for a while and would like to thank you for your informative insights as well as support.

I pose you with a rather strange “?”. My current cocktail consists of D4T,

DDI, and Viracept, which I've been following for well over the past 11

months. Fortunately, I have not developed any peripheral neuropathy side

effects of D4T or DDI at this point , however, I recently experienced a

“grand mal seizure” followed by another. Because I have no past genetic or

family history of epilepsy, no cranial or past injuries to the head, the cause of

such a seizure leads me to believe that my experience is due to chemical

influence mainly the neurotropic meds I am presently being administered. I

must point out that my hypothesis takes into consideration the recent results

of a negative CATscan and clear spinal fluid ; I am HIV for 13 years and have

never had any past neurological disorders.

Could you please give me you insight on your thoughts of this matter, and the

new realm of long term use we are moving into with these neurotropic

medications?

Thanks.

Response from Dr. Gallant

I have not seen seizures resulting from any of the antiretrovirals, including the "d-drugs," which cause peripheral neuropathy but not central nervous system side effects.

I would look elsewhere for an explanation. A CAT scan can be rather insensitive for a number of HIV-related brain lesions. A contrast-enhanced MRI scan is usually preferred. An EEG might also be in order.

Before you change what sounds like a good regimen, I'd talk to an HIV-experienced neurologist.

JG



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