Neurological manifestations in advanced HIV infection present major diagnostic challenges
because multiple overlapping etiologies may coexist. Progressive motor weakness with mixed
upper and lower motor neuron signs requires careful evaluation to exclude opportunistic
infections, spinal cord pathology, metabolic causes, and alcohol-related neurological disorders.
This presentation highlights a complex case of cerebral toxoplasmosis in advanced HIV
infection associated with alcoholic peripheral neuropathy and proximal myopathy,
emphasizing diagnostic reasoning, multidisciplinary management, and rehabilitation.