Patient is ambulatory but may require a single prop. Intellectual and social comprehension and output are at a rudimentary level. Patient is nearly or absolutely mute. Patient is paraparetic or paraplegic with urinary and fecal incontinence. Although the presence or absence of focal neurological signs is a useful diagnostic criterion, it may be misleading, since these patients often have more than one neurological condition.
Oligoclonal bands are sometimes present.
HIV antibodies are present. Several cytokines, chemokines, and other soluble factors are increased, including beta-2 microglobulin, neopterin, and quinolinic acid. Dopamine levels are reduced. Serum studies Vitamin B-12 and folic acid levels should be determined and, if necessary, corrected. In cases of borderline low B-12 levels, homocysteine and methylmalonic acid levels are better indicators of a deficiency.