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A viral etiology for ALS has long been hypothesized because of the selective vulnerability of motor neurons to certain viruses.1 In the 1960s and 70s, poliovirus was the darling of those proposing a viral etiology2 because of its relatively selective infection of motor neurons, the occasional reports of antecedent poliomyelitis in patients with ALS, and the frequent occurrence of chronic progressive weakness many years after acute poliomyelitis, now recognized as the post-polio syndrome (PPS).3 Most patients with PPS have only lower motor neuron disease, but a small percentage also have upper motor neuron signs and present with features suggestive of ALS.3,4⇓ Although prior attempts to isolate polioviruses and other enteroviruses from the CNS of patients with ALS have failed,5 newer technologies may prove valuable in helping to establish a possible viral etiology.6
In this issue of Neurology, seven cases of ALS syndromes accompanying HIV infection are reported.7,8⇓ The retroviruses, like HIV, are ideal candidates …
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- Does viral disease underlie ALS?: Lessons from the AIDS pandemic
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