title: Motor neuron disease and acquired axonal neuropathy association in HIV infection: case report and update.
abstract: BACKGROUND
  A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis - Syndrome, Motor Neuron Diseases and peripheral neuropathies.
  
  
  OBJECTIVE
  To report a case of an association between Motor Neuron Disease and Acquired Axonal neuropathy in HIV infection, and describe the findings of neurological examination, cerebrospinal fluid, neuroimaging and electrophysiology.
  
  
  METHODS
  The patient underwent neurological examination. General medical examinations were performed, including, specific neuromuscular tests, analysis of cerebrospinal fluid, muscle biopsy and imaging studies.
  
  
  CONCLUSIONS
  The initial clinical presentation of our case was marked by cramps and fasciculations with posterior distal paresis and atrophy in the left arm. We found electromyography tracings with deficits in the anterior horn of the spinal cord and peripheral nerves. Dysphagia and release of primitive reflexes were also identified. At the same time, the patient was informed to be HIV positive with high viral load. He received antiretroviral therapy, with load control but with no clinical remission.
  
  
  CONCLUSIONS
  Motor Neuron disorders and peripheral neuropathy may occur in association with HIV infection. However, a causal relationship remains uncertain. It is noteworthy that the antiretroviral regimen may be implicated in some cases.
authors.affiliation: Neurology Department, Antonio Pedro University Hospital, Federal Fluminense University, Rio de Janeiro, Brazil.
authors.forename: Marco
authors.initials: M
authors.lastname: Orsini
authors.forename: Marcos R G
authors.initials: MR
authors.lastname: de Freitas
authors.forename: Julio G
authors.initials: JG
authors.lastname: Silva
authors.forename: Márzia P
authors.initials: MP
authors.lastname: Sohler
authors.forename: Carlos H M
authors.initials: CH
authors.lastname: Reis
authors.forename: Antonio M
authors.initials: AM
authors.lastname: da Silva Catharino
authors.forename: Acary B
authors.initials: AB
authors.lastname: Oliveira
authors.forename: Sérgio
authors.initials: S
authors.lastname: Machado
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
authors.forename: Peter
authors.initials: P
authors.lastname: Salem
authors.forename: Flavio
authors.initials: F
authors.lastname: Sztajnbok
authors.forename: Marco A A
authors.initials: MA
authors.lastname: Leite
authors.forename: Cristiane
authors.initials: C
authors.lastname: Nascimento
authors.forename: Eduardo
authors.initials: E
authors.lastname: Davidovich
authors.forename: Fábio H
authors.initials: FH
authors.lastname: de Gobbi Porto
authors.forename: Márcia W
authors.initials: MW
authors.lastname: Cruz
authors.forename: Sara L S
authors.initials: SL
authors.lastname: de Menezes
authors.forename: Oscar
authors.initials: O
authors.lastname: Arias-Carrión
mesh_terms: D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*