A rare presentation of reversible ALS in HIV infection

Abstract Amyotrophic lateral sclerosis (ALS) is the most common type of motor neuron disease (MND) [1] . It is usually associated with an irreversible course, and treatable causes of ALS are rare. Here, we present a case report of a 35-year-old male, with progressive weakness and wasting of muscles in all four limbs with fasciculation and electro diagnostic features compatible with a diagnosis of probable ALS. He was later diagnosed to have HIV infection and initiated on anti-retroviral therapy. On 6 months follow-up, he had a weight gain of 8 kg and electro diagnostic studies revealed near total normalization of the neurogenic pattern. Reversible ALS like illness in HIV infection has been documented in literature but most of them are diagnosed cases of HIV infection. This case identifies the importance of identifying reversible causes of ALS and near total response to treatment in a patient who presented to us with MND features as the only manifestation of HIV infection.