How are neurological complications of AIDS diagnosed?

Neurological complications of AIDS are quite broad and involve both central and peripheral nervous systems. They include dementia, myelopathy, neuropathy, myopathy and aseptic meningitis. Patients can also develop opportunistic infections with involvement of the central nervous system (meningitis or encephalitis), progressive multifocal leukoencephalopathy (PML) and CNS lymphoma. In order to diagnose these conditions, several different tests need to be performed. The central nervous system involvement (dementia, myelopathy, lymphoma, PML) can be evaluated with MRI or CT scan imaging of the brain and the spinal cord. The presence of infection can be tested by performing cerebrospinal fluid(CSF) analysis. Peripheral nerve disease (neuropathy) is diagnosed with the help of nerve condition studies and electromyography (NCS/ EMG).

Based on the results of the patient's medical history and a general physical exam, the physician conducts a thorough neurological exam to assess various functions: motor and sensory skills, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior. The physician may order laboratory tests and one or more of the following procedures to help diagnose neurological complications of AIDS.

Computer-assisted imaging can reveal signs of brain inflammation, tumors and CNS lymphomas, nerve damage, internal bleeding or hemorrhage, white matter irregularities, and other brain abnormalities. Several painless imaging procedures can help diagnose neurological complications of AIDS.

Computed tomography (CT Scan) Magnetic resonance imaging (MRI) Functional MRI (fMRI) Magnetic resonance spectroscopy (MRS)

Electromyography, or EMG, is used to diagnose nerve and muscle dysfunction, such as neuropathy and nerve fiber damage caused by the HIV virus and spinal cord disease. It records spontaneous muscle activity and muscle activity driven by the peripheral nerves.

Biopsy is the removal and examination of tissue from the body. A brain biopsy, which involves the surgical removal of a small piece of the brain or tumor, helps determine intracranial disorders and tumor type. Unlike most other biopsies, this procedure requires hospitalization. Muscle or nerve biopsies can help diagnose neuromuscular problems, while a brain biopsy can help diagnose a tumor, inflammation, or other irregularity.

Cerebrospinal fluid analysis can detect any bleeding or brain hemorrhage, infections of the brain or spinal cord (such as neurosyphilis), and any harmful buildup of fluid. A sample of the fluid is removed by needle, under local anesthesia, and studied to detect any irregularities.

This answer is based on source information from National Institute of Neurological Disorders and Stroke.

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