The prevalence and patterns of peripheral neuropathy in 50 children with HIV infection were analyzed retrospectively in the EMG Section, National Institutes of Health, Bethesda, MD. Sensory complaints were the most common reason for referral for EMG. Of 19 children with neurological abnormalities, sensory loss or hypoactive reflexes, 10 had abnormal nerve conduction studies (NCS). In 7 children, NCSs were compatible with a distal symmetric sensory or sensorimotor axonal polyneuropathy (DSPN). All had advanced disease and had received antiretroviral agents; in one the neuropathy was linked to vincristine treatment. Three children had median nerve compression at the carpal tunnel; two had received AZT. Of 2 additional patients with abnormal NCS, one had a demyelinating neuropathy which improved after AZT, and one had a lumbosacral polyradiculopathy associated with varicella zoster involving legs and buttocks. Distal symmetric polyneuropathy affected older children. [1]

COMMENT. The various patterns of peripheral neuropathy encountered in children with HIV resemble those described in adults. The most common type is a demyelinating sensory or sensorimotor polyneuropathy.