Almeida Vânia, Mestre Tiago, De Carvalho Mamede
Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal.
Amyotroph Lateral Scler. 2010;11(1-2):220-2. doi: 10.3109/17482960902748694.
Different forms of motor neuron disease occurring in association with HIV infection have been described. We present two patients with pseudobulbar syndrome and HIV infection, with no clinical or electromyographic signs of lower motor neuron loss. In patient 1, on follow-up, focal seizures led to additional investigations that identified unsuspected HIV infection and progressive multifocal leucoencephalopathy (PML). In patient 2, all investigations excluded an active HIV infection or central nervous system involvement, and the disease progression made primary lateral sclerosis (PLS) with pseudobulbar onset the most likely diagnosis. ALS-like syndrome can occur in association with HIV infection; however, the causal relationship remains uncertain. Patient 1 shows that PML is a possible cause for pseudobulbar syndrome, and our second patient demonstrates that ALS may also occur by chance in patients with HIV infection.
与HIV感染相关的不同形式的运动神经元病已被描述。我们报告了两名患有假球麻痹综合征和HIV感染的患者，他们没有下运动神经元丧失的临床或肌电图表现。在患者1中，随访时局灶性癫痫发作促使进一步检查，发现了未被怀疑的HIV感染和进行性多灶性白质脑病（PML）。在患者2中，所有检查均排除了活动性HIV感染或中枢神经系统受累，疾病进展使假球麻痹起病的原发性侧索硬化症（PLS）成为最可能的诊断。类似肌萎缩侧索硬化症（ALS）的综合征可与HIV感染相关；然而，因果关系仍不确定。患者1表明PML是假球麻痹综合征的一个可能原因，我们的第二位患者表明ALS也可能偶然发生在HIV感染患者中。
