Motor neuron disease in patients with HIV infection: Report of two cases and brief review of the literature.

HIV-associated motor neuron disease (MND), or amyotrophic lateral sclerosis (ALS)-like syndrome associated with HIV infection, is a rare manifestation of HIV infection. HIV-associated MND has only been identified in few cases to date. We analysed two Brazilian patients with HIV infection who developed MND. The diagnosis of HIV infection was concomitant with diagnosis of MND in one patient and it occurred eight years before the MND symptoms in another patient. The manifestation of MND in our patients with HIV infection was similar to classic ALS. The antiretroviral therapy improves their HIV infection. However, slow progression of MND occurred in the two patients despite their antiretroviral therapy or HIV viral load (undetectable). We revised the international literature (PubMed database) of the patients reported with MND and HIV infection.

[Amyotrophic lateral sclerosis and herpes virus. Report of an unusual case: a cause or casual association?]. / Esclerose lateral amiotrófica e Herpes virus. Relato de um caso curioso: uma associação casual ou causal?

OBJECTIVE: To present a curious case of amyotrophic lateral sclerosis (ALS). CASE: A forty-seven year old man claimed of paresis in the arms since four years. The electrical study of the muscles and nerves diagnosis was ALS, type Vulpian-Bernardt. The cerebrospinal fluid study revealed an inflammatory process and the positivity of immulogical reactions for Herpes simplex I. The blood-brain barrier study showed the possibility that immunological response for Herpes simplex I was produced in the spinal fluid space. A magnetic resonance suggested cystic myelopathy of cervical spinal cord expanding from C2 to C4. The patient received endovenous acyclovir for 21 days. Until two months after the medication we did not submit the patient to other subsidiary examinations. DISCUSSION: Until now there is no specific drug treatment for ALS. The notion that there is a "syndrome of ALS" related with various causes may help to treat some patients.

Esclerose lateral amiotrófica e herpes virus: relato de um caso curioso: uma associaçäo casual ou causal? / Amyotrophic lateral sclerosis and herpes virus: Report of a curious case: a cause or casual association?

Objetivo: Apresentar o relato de um caso de esclerose lateral amiotrófica (ELA). Caso: Homem de 47 anos que apresentava déficit de força nos membros superiores evoluindo há 4 anos. A eletroneuromiografia era compatível a ELA, forma de Vulpian-Bernardt. O estudo do líquido cefalorraqueano (LCR) mostrava processo inflamatório e positividade das reaçoes para Herpes vírus I e II. O estudo do LCR, do soro sanguíneo e da barreira hemato-encefálica sugeria imunoproduçao local para Herpes vírus tipo I. A ressonância nuclear magnética sugeria mielopatia cística ou seringomielia em medula cervical estendendo-se nos espaços C2 a C4. O paciente foi tratado com aciclovir endovenoso por 21 dias. Até dois meses após, o paciente nao foi submetido a novos exames subsidiários para controle. Discussao: Até o momento atual, a doença ELA nao tem tratamento medicamentoso específico. A noçao da existência de "síndrome esclerose lateral amiotrófica" associada a etiologias diversas pode contribuir para o tratamento de alguns doentes.