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December 1993

Lower Motor Neuron Dysfunction Associated With Human Immunodeficiency Virus Infection

Author Affiliations

From the Department of Neurology, Bellevue Hospital, New York (NY) University Medical Center.

Arch Neurol. 1993;50(12):1328-1330. doi:10.1001/archneur.1993.00540120041011

Objective:  The association of human immunodeficiency virus with a clinical picture of motor neuron disease is uncommon, with three cases reported to date. This case represents an additional case of a human immunodeficiency virus—infected patient with apparent motor neuron disease.

Design:  Single patient case report.

Setting:  Large urban public hospital.

Patient:  A 45-year-old human immunodeficiency virus—positive Hispanic man who presented with muscle wasting, fasciculations, areflexia, cranial nerve deficits, and weakness progressing to a complete quadriplegia.

Results:  Electrophysiologic data showed evidence of diffuse denervation with normal sensory and motor nerve conductions and no evidence of demyelination. Electromyography showed diffuse sharp waves and fibrillation.

Conclusions:  This case demonstrates a progressive motor neuron dysfunction in a patient positive for the human immunodeficiency virus and provides additional evidence that infection with the human immunodeficiency virus should be considered in the differential diagnosis of apparent motor neuron disease.