HIV infection also involves spinal cord pathologically by vacuolation of the white matter. Myelopathy is usually seen in late stages of HIV infection and many patients have concomitant encephalopathy. Leg weakness due to spastic paraparesis with sphincteric incontinence and sensory ataxia are seen. CSF examination is done to see presence of HIV infection and to exclude cytomegalovirus polyradiculopathy. MRI and CT scan are done to rule out presence of epidermal lymphoma. Thus diagnosis of HIV myelopathy is by exclusion only.
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