Facial Diplegia and Vestibular Neuritis Secondary to HIV Seroconversion Syndrome
Bibliographic record
Abstract
Peripheral nerve involvement is a frequent complication of Human Immunodeficiency Virus (HIV) infection 1 .Among cranial nerves, the seventh is the most commonly affected 2 .However, facial diplegia is a rare clinical entity in the HIV infected population.We recently observed a case that is of particular interest, since the patient developed facial diplegia and unilateral vestibular neuritis revealing HIV infection. CASE REPORTThe patient is a 60-year-old heterosexual male with a past medical history of morbid obesity and chronic obstructive pulmonary disease.He had been in his usual state of health until approximately four weeks prior to admission, when he developed low grade fever, rhinorrhea, sore throat and diffuse arthromyalgias.Fever resolved promptly after treatment with amoxycillin and clavulanic acid.Later on he was admitted to our institution with a five-day history of constant dizziness, unsteadiness and imbalance.By the time of admission he additionally experienced perioral numbness followed suddenly by lack of facial movements, with failure of both eyes to close and difficulty in sucking, smiling and talking.Neurological examination revealed bilateral peripheral facial palsy, rightdeviation tendency in past pointing and Quix tests, and mild unsteadiness with gait deviation to the right.The remainder of physical and neurological examination was normal, including intact reflexes.Laboratory studies disclosed an erythrocyte sedimentation rate of 51 mm/h.White blood cell count was 12.4 x 10 9 cells/l, with 35.6% neutrophils, 48.6% lymphocytes and 12.3% monocytes.Red blood cell and platelet counts were within normal limits.Autoantibody screening tests and blood biochemistry parameters, including angiotensin converting enzyme, were also normal.Cerebrospinal fluid (CSF) contained 30 cells/µl with 93% lymphocytes, protein 1.64 g/l and glucose 2.6 mmol/l (serum glucose 6.7 mmol/l).Cytology was negative.No organism was seen on Gram-stained smear, and cultures of CSF for bacterial, mycobacterial, viral and fungal organisms were also negative.Polymerase chain reaction and serologies for citomegalovirus, varicella zoster virus, Epstein-Barr virus, type 1 and 2 herpes simplex virus, Toxoplasma gondii, Cryptococcus, Brucella, Treponema pallidum, and Borrelia burgdorferi were negative in both serum and CSF.Human Immunodeficiency Virus testing was positive by ELISA and was confirmed by Western blot.CD4 + cell count was 252 cells/µl and CD8 + cell count was 5027 cells/µl, with CD4/CD8 ratio at 0.05.Viral RNA load was 197 000 copies/ml.A gadolinium enhanced brain magnetic resonance imaging showed normal findings.Electrophysiological study confirmed severe impairment of
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".