Concerning CNS involvement in AIDS:
A. Toxoplasma may give rise to a foal lesion with neurological weakness.B. The HIV virus can be isolated from the brain of anencephalopathic patient.
C. A diagnostic elevation in the CSF IgM occurs in toxoplasmic infection.
D. Cerebral toxoplasmosis can be treated by Pyrimethaminealone.
E. Occular involvement may cause blindness.
Ans. A,B,E
Cerebral
toxoplasmosis presents very variably, from an acuteencephalopathy to subtle
neurological syndromes. It should beconsidered in all undiagnosed
neurologicaldisease in the under ones, especially if there are retinal lesions.
Characteristic are
hydrocephalus, seizures with focal defects,spinal or bulbar palsies,
microcephaly, and decreased IQ.
Investigations
such as skull x-ray or CT scan show calcificationof the periventricular area,
tachyzoites in the CSF and positiveblood titres. Pyrimethamine and
Sulphadiazine have asynergistic effect in treating it, and folinic acid may be
necessary to
prevent seizures.
