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In a prospective follow-up period from September 1987 to August 1988, the AIDS dementia complex (ADC) was the presenting clinical feature in six of 102 patients in whom AIDS was diagnosed in the Hospital Clínic i Provincial from Barcelona. The clinical picture was characterized by subcortical type deterioration and motor disturbances. Cerebrospinal fluid investigation and imaging techniques excluded other types of neurological involvement, and the diagnosis was confirmed at autopsy in two patients. The present study suggested that: 1) the ADC may be the presenting feature of AIDS in patients with unknown seropositive status; 2) in our area, ADC represents one of the most common causes of dementia in young patients, and 3) although a specific marker permitting a definitive clinical diagnosis is not available, at the time of diagnosis all patients had a severe degree of cellular immunosuppression induced by type 1 human immunodeficiency virus.
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