[Anterior spinal artery infarct: amyotrophic lateral sclerosis-like]

ABSTRACT

Psychiatric disorders accompanying infection with human immunodeficiency virus are frequent and varied. They canthe medullary infarct is a rare injury, with a difficult diagnosis. Usually, it is due to an aortic disease or to iatrgenic cause. We relate the observation of a patient presenting an anterior spinal infarct simulating an amyotrophic lateral sclerosis. Through this observation, we discuss the particular semiology of this medullar pathology. A 15-year-old girl, who developed sudden tetraparesis, tetrapyramidal syndrome and amyotrophy of the hands. The medullary MRI showed an extended hypersignal from C3 to C6 [compatible with an infarct in the anterior spinal artery territory]. The etiologic investigations were unremarkable. The clinical presentation of our patient and MRI results confirm the diagnosis of medullar infarct but absence of any objective sensory disorder suggest an ALS-like syndrome. The anterior horn cell region is in the most distally perfused part of the anterior spinal artery territory and is vulnerable to hypoperfusion. It can explain the clinical picture. The diagnosis of spinal cord infact must be suspected in case of atypical ALS syndrome with sudden onset