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4.3.5 – Sensation

Children can get peripheral neuropathies in the same way as adults living with HIV. Recent studies in Sub-Saharan Africa have shown that peripheral neuropathy is much more common than had been thought and may affect as many as 24% of children.7

Peripheral neuropathy in adults has been linked to the use of nucleoside reverse transcriptase inhibitors (NRTIs) and this class of drug is still included in first line paediatric ART regimes in Africa.7

Children may present with numbness, burning and tingling sensations in their feet. They may have decreased sensation and reduced or abnormal ankle reflexes8.

Many children who have been on ART since they were very young will not complain of symptoms as they have grown up with these abnormal sensations and do not consider them out of the ordinary.

Table 4.3.5: Clinical Aspects of Sensory Impairments

Impairments Possible Etiologies Rehabilitation Interventions6
Sensation changes, including numbness, burning or tingling

HIV

Peripheral neuropathy

  • All children should be screened for peripheral neuropathy. Do not wait for complaints about altered sensation.
  • Assess children’s balance and proprioception
  • Monitor children’s gait pattern
  • A programme consisting of deep pressure and/or vibration, balance and gait re-education as well as proprioceptive training is advised.

6Choice of rehabilitation interventions will depend on patient assessment and available resources.

7Peters R, Van Ramshorst M, Struthers H, McIntyre J. Clinical assessment of peripheral neuropathy in HIV-infected children on antiretroviral therapy in rural South Africa. European Journal of Pediatrics. 2014; DOI 10.1007/s00431-014-2303-9

8Sankhyan N, Lodha R, Sharma S, Menon P, Choudhary A, Kabra S, Gulati S. Peripheral neuropathy in children on Stavudine therapy. Indian Journal of Pediatrics. 2014; DOI 10.1007/s12098-014-1477-5