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Pediatric Spastic Paraperesis
Apr 21, 2004

My 3 year old son was diagnosed full blown AIDS at 5 1/2 months old. He did not start walking until after he was 20 months. He is now 3 and for the past year have been questioning his gate and Cerebral Palsey similarities. Though many suggestions have been given, physical therapy ongoing and the use of CFO's and a walker, when needed he continues to struggle with balance, gate and stamina. He has also had sensitivity in his penile area. Last week he FINALLY got in to see a neurologist who diagnosed him with SPASTIC PARAPERESIS. The doctor said this is common in peds. I am having trouble finding more information on this other than familial and tropical cases. Can you help and is this common among peds... where do we go from here??

Thanks, Mom2anAngel

Response from Dr. Lee

You have said little about his treatment for HIV. I am sorry that your little angel has had such troubles in his young life. To answer what I can of your questions:

To say that spastic paraperesis is "common" in peds AIDS may depend on your definition of common. Certainly there are case reports of this occuring in children with HIV. (One study from Italy showed that about a third of the children infected with HIV at or before birth developed progressive neurologic diseases. L. Angelina and others reported "Multifocal white matter alterations and cerebral calcifications (sometimes with delayed onset and progression) were the prominent imaging findings. A correlation between cerebrospinal fluid HIV RNA levels, suggestive of viral replication within the central nervous system, and progressive neurological disease were also found."

You said little about your son's treatment, T cell levels, or other conditions. But, it would seem that his best bet to improve rather than continue to decline would be to use the most effective antiretroviral therapies available to him. Elevated HIV levels in the nervous system seem to be associated with worsening symptoms.

You and your son- be well.


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