Mortality and morbidity are dependent on the etiology. The autoimmune form may undergo spontaneous remission or respond to immunomodulation, especially when the condition presents early during HIV infection. The patient describes multifocal asymmetric sensory and motor complaints in the distribution of cranial nerves, peripheral nerves, or nerve roots. Progression may change presentation from multifocal mononeuropathies to a more generalized polyneuropathy. CMV may be causative.
Histologic findings show axonal degeneration with perivascular mononuclear infiltrates.
Occasionally, the infiltrate is predominantly polymorphonuclear. CMV inclusions can be seen in mononuclear and endothelial cells, and CMV can be identified by culture or polymerase chain reaction. Occasionally, a prominent necrotizing arteritis can be seen. Potential complications include autonomic instability, hypercalcemia, and bleeding from depletion of clotting factors. Base the decision to use IVIG, plasmapheresis, or steroids on the individual patient.