Neurotologic findings of a patient with acquired immune deficiency syndrome

A Caucasian male contracted acquired immune deficiency syndrome (AIDS) following a blood transfusion during heart surgery. Four years later he developed dizziness, dysequilibrium, and emotional disturbances. Neurotologic evaluation implicated central vestibular and auditory dysfunction. Electronystagmographic findings showed ataxic pursuit and optokinetic nystagmus, with a total loss of caloric excitability. The auditory brain stem response indicated delayed absolute and interpeak latencies, and the synthetic sentence identification test yielded abnormally reduced scores bilaterally. Psychological tests suggested organic brain disease with severe anxiety and depression. At autopsy, the AIDS retrovirus was found in mononuclear and multinucleated giant cells in the cortical and subcortical gray matter, cerebral and cerebellar white matter, and throughout the brain stem. Pathologic changes were consistent with the patient’s neurotologic profile.