A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs...A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs associated with brisk muscle stretch reflexes and without any sensory or sphincter involvement. While nerve conduction tests were normal, the EMG of proximal and distal limb mu scles on both sides revealed evidence of denervation and reinnervation. Routine blood and urine tests and investigations for underlying causes of motor neuron d isease were noncontributory. He was HIV 1, subtype clade C seropositive. A diag nosis of HIV related anterior horn cell disease was considered and zidovudine, lamivudine and nevirapine were started. After 1 month, there was a subjective im provement of 10%and objective improvement in strength of muscles of proximal up per limb on both sides by one grade power on MRC scale. Reports of amyotrophic l ateral sclerosis (ALS) like illness in HIV are sparse. The reversibility of “A LS” like features in this subgroup of patients might offer an insight into the pathogenesis of amyotrophic lateral sclerosis. This is a first report of ALS l ike illness caused by subtype C of HIV 1 strain.展开更多
文摘A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs associated with brisk muscle stretch reflexes and without any sensory or sphincter involvement. While nerve conduction tests were normal, the EMG of proximal and distal limb mu scles on both sides revealed evidence of denervation and reinnervation. Routine blood and urine tests and investigations for underlying causes of motor neuron d isease were noncontributory. He was HIV 1, subtype clade C seropositive. A diag nosis of HIV related anterior horn cell disease was considered and zidovudine, lamivudine and nevirapine were started. After 1 month, there was a subjective im provement of 10%and objective improvement in strength of muscles of proximal up per limb on both sides by one grade power on MRC scale. Reports of amyotrophic l ateral sclerosis (ALS) like illness in HIV are sparse. The reversibility of “A LS” like features in this subgroup of patients might offer an insight into the pathogenesis of amyotrophic lateral sclerosis. This is a first report of ALS l ike illness caused by subtype C of HIV 1 strain.
