HIV-Associated Vacuolar Encephalomyelopathy

We report a case of HIV-associated vacuolar encephalomyelopathy with progressive central nervous system dysfunction and corresponding vacuolar degeneration of the spinal cord, cranial nerves, and brain, the anatomic extent of which has not previously been described. Vacuolar myelopathy classically presents as a spinal syndrome with progressive, painless gait disturbance in the setting of advanced HIV and AIDS. Vacuolar involvement of the brain and cranial nerves, as illustrated in this case report, is a newly described variant of this condition that we term vacuolar encephalomyelopathy.