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Neuromuscular Diseases

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Vasculitic neuropathy may occur following

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(A) hepatitis C infection

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(B) botulism

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(C) neomycin administration

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(D) Campylobacter jejuni infection

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(E) amiodarone administration

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(A) Vasculitic neuropathy may complicate the course of hepatitis C. The disorder is often painful and asymmetric skeletal muscle weakness is prominent. Central nervous system disease may accompany the neuropathy. Palpable purpura, which is due to a leukocytoclastic vasculitis, is often seen in the legs in a distal greater than a proximal distribution. The tempo of the vasculitic neuropathy may be subacute, chronic, or acute on chronic. Progression to multiorgan failure may occur, especially when the baseline viral load is high (greater than 2 to 3 million ge/mL serum) or if the hepatitis C virus genotype is 1a and 1b. (Souayah, Neurol Neurophysiol Neurosci 5; Khella, 101–106)

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Human immunodeficiency virus (HIV)–associated Guillain–Barré syndrome (GBS) occurs most often

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(A) when retroviral therapy is withdrawn

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(B) when the CD4+ cell count is less than 100/mm3

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(C) when the CD4+ cell count is less than 50/mm3

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(D) early in the course of the disease or at the time of seroconversion

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(E) following immune reconstitution

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(D) Several types of peripheral neuropathy are associated with human immunodeficiency virus (HIV) infection. GBS occurs most often at the time of seroconversion or in the early course of infections where the CD4+ cell count is relatively preserved. Occasionally, GBS is reported in an advanced stage of acquired immunodeficiency syndrome (AIDS) with a CD4+ cell count less than 50/mm3 or during immune reconstitution. (Souayah, J Neuroimmunol 188, 143–145).

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The most frequent HIV neuropathy is

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(A) mononeuritis multiplex

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(B) distal sensory polyneuropathy

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(C) motor polyneuropathy

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(D) acute inflammatory demyelinating polyneuropathy

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(E) chronic inflammatory demyelinating polyneuropathy

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(B) With the effectiveness of antiretroviral treatment and the consequent decline in the incidence rates of central nervous system infections and HIV dementia, HIV-associated neuropathies have become the most common neurological disorders associated with AIDS. The most common HIV-associated neuropathy is distal sensory polyneuropathy (DSP), a disorder characterized mostly by sensory symptoms, often including spontaneous or evoked pain with a subacute and chronic course usually developing during the advanced stages of ...

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