Which diagnostic tests are performed in the workup of HIV-associated vacuolar myelopathy (VM)?

Updated: May 07, 2018
  • Author: Krupa Pandey, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Electrophysiologic tests can support a diagnosis of vacuolar myelopathy (VM). Somatosensory evoked potential (SSEP) may be a valuable tool in the diagnosis, particularly when myelopathy and peripheral neuropathy coexist. [5]

Other studies serve to identify or rule out other potential causes of myelopathy. CSF analysis can exclude infection with cytomegalovirus(CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and HTLV-1 and 2. CSF results are usually normal in HIV-associated VM.

Serum studies candetermine B-12 and folate levels. In patients with borderline low B-12, elevated homocysteine and methylmalonic acid levels are better indicators of a deficiency. B-12 levels are usually normal in vacuolar myelopathy.

A Schilling test, hematologic studies, and CD4+ lymphocyte counts may be indicated.

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