HIV infection mimiking amyotrophic lateral sclerosis – a three-year follow-up

Abstract

In this paper we present the clinical course during 3 years of follow-up of a patient who was admitted in our clinic being formerly diagnosed with sporadic amyotrophic lateral sclerosis (ALS). After he was diagnosed in 2016 with ALS, he was treated with Riluzole for 6 months, but his symptoms aggravated in this period of time. During the first admission in our department, he presented a flail-arm syndrome with bilateral scapula alata, facio-scapulo-humeral wasting, fasciculations, abolished reflexes in the upper limbs, generalized pruritus, xeroderma and weight loss over 25 kg. Extensive investigations revealed the HIV infection for which he was referred then to the nearest infectious diseases centre for proper treatment. A follow-up spanning on 3 years, revealed increased muscle power and improved muscle bulk after HAART therapy. In this paper we present the case report and a short to the point literature review of amyotrophic lateral sclerosis mimics in HIV infection.

Keywords

• amyotrophic lateral sclerosis mimics
• hiv infection
• nervous system involvement in hiv infection
• “flail-arm” syndrome
• “man in the barrel” syndrome