Document 2935
 DOCN  M94A2935
 TI    Acute paralysis of the serratus muscle in an HIV positive patient
       treated by DDC.
 DT    9412
 AU    Faller JP; Ziegler F; Balblanc JC; Labouret P; Ruyer O; Centre
       Hospitalier, Belfort, France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):191 (abstract no. PB0193). Unique
       Identifier : AIDSLINE ICA10/94369640
 AB    OBJECT: to document paralysis of the serratus muscle as a manifestation
       of HIV infection in AIDS with no other neuropathical manifestations. A
       35 years old HIV infected man (risk factor: homosexual, stage II B, CD4
       cell count: 192) had been on DDC therapy for 2 months when he was
       evaluated for a one week history of acute pain in the right scapula,
       occurring more frequently at night. The diagnosis of complete paralysis
       was clear, due to the typical signs of excessive adduction of the
       scapula edge with the foward movement of the arm (picture 1). No sensory
       disturbance was reported and examination revealed hyporeflexia biceps
       jerk. Our nerve conducted study on day 15 revealed a small neurogenic
       atrophia with no increase in distal latency. The second study on day 45
       revealed no spontaneous dernervation and suggested C6 radiculoneuritis.
       The patient refused lumbar puncture. There was no evidence in particular
       of cytomegalovirus, Herpes Simplex Virus, Epstein Barr Virus. An MRI
       showed no herniated disk. Despite continued DDC treatment, a marked
       clinical improvement was observed. Functional recovery was almost
       complete in 3 months time. DISCUSSION AND CONCLUSION: our case differs
       from the traditional description of this type of paralysis precisely
       because of the absence of Havresac syndrome, Parsonage-Tuner syndrome, a
       herniated disk or vaccination in this area. There was improvement
       despite therapy. Our results suggest the possible implication of the HIV
       virus, another infection, or autoimmune mechanism. No such cases have
       previously been reported in HIV patients to our knowledge. We are
       therefore alerting clinicians that there may be a link between HIV
       infection and this type of this neuropathical manifestation.
 DE    Adult  Follow-Up Studies  Human  HIV Seropositivity/*DIAGNOSIS/DRUG
       THERAPY  Male  Muscles/INNERVATION  Muscular Atrophy/DIAGNOSIS/DRUG
       THERAPY  Neurologic Examination/DRUG EFFECTS  Paralysis/*DIAGNOSIS/DRUG
       THERAPY  Radiculitis/*DIAGNOSIS/DRUG THERAPY  Scapula/*INNERVATION
       Zalcitabine/THERAPEUTIC USE  MEETING ABSTRACT

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