Acute lower motor neuron syndrome and spinal cord gray matter hyperintensities in HIV infection

Abstract

Objective:To describe a novel manifestation of lower motor neuron disease in patients with well-controlled HIV infection.Methods:A retrospective study was performed to identify HIV-positive individuals with acute, painful lower motor neuron diseases.Results:Six patients were identified with HIV and lower motor neuron disease. Two patients met the inclusion criteria of well-controlled, chronic HIV infection and an acute, painful, unilateral lower motor neuron paralytic syndrome affecting the distal portion of the upper limb. These patients had segmental T2-hyperintense lesions in the central gray matter of the cervical spinal cord on MRI. One patient stabilized and the second patient improved with immunomodulatory therapy.Conclusions:This newly described syndrome expands the clinical spectrum of lower motor neuron diseases in HIV.

Acute flaccid myelitis in childhood: a retrospective cohort study

“…Two of the children in this cohort had illnesses consistent with the clinical syndrome described by Hopkins. These entities are probably variants of the same condition, as are recently described cases in adults with human immunodeficiency virus .…”

HIV-associated motor neuron disease

“…In a prior literature review, we had identified 29 cases. 1 Since then, one case of HIV infection and ALS-like disorder 22 and another 7 cases with a lower motor neuron disorder have been reported. 22,23 In one study of 1,700 patients with HIV infection, the prevalence of HIV-associated ALS was estimated as 3.5 cases/ 1,000 patients.…”

“…1 Since then, one case of HIV infection and ALS-like disorder 22 and another 7 cases with a lower motor neuron disorder have been reported. 22,23 In one study of 1,700 patients with HIV infection, the prevalence of HIV-associated ALS was estimated as 3.5 cases/ 1,000 patients. 22 In comparison, the incidence of ALS in the general population is approximately 1 or 2 cases per 100,000/year and the prevalence is 4 to 6 cases per 100,000.…”

“…22,23 In one study of 1,700 patients with HIV infection, the prevalence of HIV-associated ALS was estimated as 3.5 cases/ 1,000 patients. 22 In comparison, the incidence of ALS in the general population is approximately 1 or 2 cases per 100,000/year and the prevalence is 4 to 6 cases per 100,000. 24 While the clinical presentation of HIV-associated MND is indistinguishable from sporadic ALS, the patients with HIV are typically younger, nearly all the cases are younger than 40 years of age at the time of onset of neurologic symptoms, and most of these patients are male.…”

The first anniversary issue

“…Bogoch et al 9 report 2 HIV-positive patients who developed a novel syndrome characterized by an acute, painful, unilateral lower motor neuron paralysis affecting the distal portion of the upper limb. Both patients had segmental T2-hyperintense lesions in the central gray matter of the spinal cord.…”