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Cranial Neuropathy Heralding Otherwise Occult AIDS-Related Large Cell Lymphoma
J Clin Neuro-Ophthalmol 13:113-118, Berger,J.R.,et al, 1993
See this aricle in Pubmed

Article Abstract
Three HIV-infected patients developed cranial neuropathy as the initial manifestation of an AIDS-related large cell lymphoma.All were homosexual men known to be HIV seropositive for 3 t0 4.5 years.At the time of presentation for neurological disease,the CD4 T-lymphocyte count was<400 cells/mm3 in each.Initial manifestations were retro-orbital headache and oculomotor nerve palsy in two and an abducens nerve palsy in the other. Repeatedly negative CSF cytologies and recovery of the cranial neuropathy obscured the diagnosis.These patients illustrated that cranial neuropathy with HIV infection may herald the presence of an occult large cell lymphoma.Spontaneous or corticosteroid-associated improvement of the cranial neuropathy,absence of abnormalities on brain imaging studies,and negative CSF cytologies do not exclude this diagnosis.We suggest that a diligent and repeated search for lymphoma be considered in HIV-infected patients presenting with cranial neuropathy,including repeated CSF examinations,MRI of brain and spine(T1 and T2)with an without gadolinium enhancement,chest and abdominal CT scans,and bone marrow biopsy.
 
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abducens nerve paralysis
acquired immunodeficiency syndrome
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CAT scan,abdomen
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cerebrospinal fluid,cytology
cerebrospinal fluid,cytology,false negative
cranial nerve enhancement
cranial nerve palsies
cranial nerve palsies,unilateral
cranial nerves
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cranial neuropathy,multiple
diplopia
facial nerve palsy
gadolinium
headache
heralding manifestation
hip pain
homosexual
human immunodeficiency virus type 1
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lymphoma involving CNS
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MRI,contrast enhanced
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pain
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pleocytosis of cerebrospinal fluid
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