Acute lower motor neuron syndrome and spinal cord gray matter hyperintensities in HIV infection

OBJECTIVE To describe a novel manifestation of lower motor neuron disease in patients with well-controlled HIV infection. METHODS A retrospective study was performed to identify HIV-positive individuals with acute, painful lower motor neuron diseases. RESULTS Six patients were identified with HIV and lower motor neuron disease. Two patients met the inclusion criteria of well-controlled, chronic HIV infection and an acute, painful, unilateral lower motor neuron paralytic syndrome affecting the distal portion of the upper limb. These patients had segmental T2-hyperintense lesions in the central gray matter of the cervical spinal cord on MRI. One patient stabilized and the second patient improved with immunomodulatory therapy. CONCLUSIONS This newly described syndrome expands the clinical spectrum of lower motor neuron diseases in HIV.