HIV Infection Presenting With Motor Axonal Variant of Guillain-Barré Syndrome

OBJECTIVES: We present a case of acute motor axonal neuropathy in a patient with previously unrecognized human immunodeficiency virus (HIV) infection. METHODS: A 46-year-old male graduate student from Mali, Africa presented with a 3-week history of progressive weakness that began during a visit home from Utah. The symptoms stabilized by 6 weeks and gradually improved without treatment. RESULTS: Electrodiagnostic studies revealed widespread fibrillation potentials and positive sharp waves with normal sensory amplitudes and no demyelinating features. Cerebrospinal fluid pleocytosis and elevated protein prompted a test for HIV infection, which returned positive. CONCLUSIONS: To our knowledge, this is the first case of acute motor axonal neuropathy in HIV outside of a seroconversion reaction.