ABSTRACT
Distal sensory polyneuropathy (DSP) has become the most frequent neurologic syndrome associated with HIV infection, and the pain associated with this condition can be debilitating. Occurring in the middle and late stages of HIV infection, DSP commonly presents as painful feet. The diagnosis of the peripheral neuropathy syndrome in HIV-infected patients is generally based upon the clinical picture. DSP commonly presents as tingling and numbness in the toes bilaterally, and then gradually spreads proximally from the lower extremities, rarely involving the upper extremities. The pathogenesis of DSP is not well understood and is thought to be multifactorial. Management of DSP is largely symptomatic and usually aimed at ameliorating the painful dysesthesias. Various classes of medication have been used in the treatment of DSP. Gabapentin has been widely used in the treatment of DSP. The use of memantine for the treatment of HIV-associated peripheral neuropathy was evaluated in a placebo-controlled study enrolling 45 subjects.
