Does a retrovirus cause amyotrophic lateral sclerosis?

✍ Scribed by W. King Engel

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 213 KB
• Volume: 30
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410300323

✦ Synopsis

was micrographic. There was no ataxia in the finger-to-nose and heel-to-knee tests. Gait was normal, although a reduced right arm swing was observed. There was no tremor and muscle tone was normal. Formal tests for apraxia did not show significant abnormalities. A brain CT scan showed an area of hypodensity in the subcortical white matter in the left hemisphere underlying the SMA (Fig) . The patient was discharged 3 weeks later with a right hand motor function nearly normal.

This case illustrates a variant of DCHS, different in its anatomical and pathophysiological basis from that of Glass and associates 12). Our patient's clumsiness was in fact bradykinesia, probably related to the lesion underneath the SMA, which may produce deafferentation of this area of the frontal cortex from the basal ganglia [6]. Indeed, patients with SMA lesions may experience difficulty in performing simple but mainly simultaneous and sequential movements, showing a motor disorder similar to that of patients with Parkinson's disease 16, 71.

We believe that the DCHS should be more precisely defined. Terms such as "dysarthria-ataxic hand" or "dysarthria-bradykinetic hand" might be useful to improve clinical-anatomical correlations.