Als-like syndrome in the patient with chronic hepatitis C

Amyotrophic lateral sclerosis (ALS) is the most common and most severe form of the motor neuron disease. The etiology of ALS is unknown. Several underlying causes are proposed, including viral infection. There is clinical evidence suggesting that ALS may be associated with Human Immunodeficiency Virus. Besides, enterovirus RNA sequences have been detected in a spinal cord of patients with ALS. We describe a patient with a 9 year history of hepatitis C, with a progressive weakness and atrophy of the right arm. Neurologic examination revealed bilateral hypotrophy and fasciculations of brachial girdle muscles more expressed on the right. No sensory or sphincter deficit was present. Nerve conduction studies and EMG were performed. Local EMG of the right deltoid muscle revealed a 4-5th stage lesion of peripheral neuromotor system, characteristic to neurogenic disease. Viruses can be one of the triggering factors of ALS. HV has never been associated with ALS. However, we found it interesting to describe this case of ALS-syndrome developed on the background of the chronic hepatitis C to draw attention of specialists on the possible role of HCV in ALS.