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CASE REPORT
Year : 2014  |  Volume : 2  |  Issue : 1  |  Page : 30-33

Amyotrophic lateral sclerosis as sole neurological manifestation of human immunodeficiency virus


Department of General Medicine, IPGMER, Kolkata, West Bengal, India

Correspondence Address:
Subrata Chakrabarti
Room No. 414, Doctor's Hostel, IPGMER, AJC Bose Road, Kolkata 700 020, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-9157 .135746

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Motor neuron diseases (MND) are extremely rare neurological manifestations of human immunodeficiency virus (HIV). We report a case of a 33-year-old known HIV seropositive male who presented with progressive asymmetrical onset of weakness and wasting of both distal limbs along with dysphagia and difficulty in speech. Examination revealed significant atrophy with visible fasciculations in thenar and hypothenar areas of both hands and dorsum of both feet associated with brisk deep tendon reflexes and jaw jerks, but diminished gag reflexes. Electromyography revealed evidence of denervation pattern. Investigations for underlying causes of MND other than HIV were noncontributory. Administration of riluzole along with continuation of antiretroviral therapy brought significant relief to his limb weakness, but bulbar features continued to progress. The case report highlights the rare, but definite association between HIV and amyotrophic lateral sclerosis (ALS) and partial reversibility of disabling clinical features on highly active antiretroviral therapy, which mandates ruling out HIV in all cases of ALS.


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