Hepatitis C: A review of its neurologic complications

BACKGROUND- Hepatitis C viral (HCV) infection is common in the general population and can cause disease in the nervous system. This article reviews the neurologic complications associated with this virus. REVIEW SUMMARY- A vasculitic neuropathy is the most firmly linked neurologic illness associated with HCV infection. This type of neuropathy occurs frequently in the presence of cryoglobulinemia. HCV is considered the most common cause of cryoglobulinemia. Other types of neuropathy have been rarely reported with HCV infection and this association is less firm. In the central nervous system, vasculitis causing stroke appears to complicate HCV infection, usually in the setting of cryoglobulinemia. Several reports of myelitis, encephalitis, and lymphoma are reviewed. HCV may be the etiologic virus of progressive encephalomyelitis with rigidity; a rare disorder similar to stiff-man syndrome although different because it is progressive and fatal. Treatment of the neurologic complications associated with HCV infection is summarized. CONCLUSIONS- HCV infection is being increasingly recognized as a probable cause of a variety of neurologic disorders. Systematic study of the various therapeutic options remains unexplored.