Lower motor neuron dysfunction associated with human immunodeficiency virus infection.

ABSTRACT

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.