A 47-year-old man with a history of HIV infection presented with an 8-month history of severe paroxysmal shooting pains in his legs, progressive difficulty in walking, tinnitus, and urinary incontinence. He had fully suppressed HIV viral load and a CD4+ count of 400 cells/mm 3 while receiving ART. The pupils were non-reactive to bright light. The man would briskly constrict his muscles when focusing on near object.
What would be the most likely diagnosis for this patient? *This case is from Docplexus editorial team for education purpose only. Source: NEJM
