Primary Lateral Sclerosis: A Clinical Diagnosis Reemerges Academic Article Article uri icon


MeSH Major

  • Bile Duct Diseases
  • Liver Abscess, Amebic
  • Sepsis


  • Adults with slowly progressive noninherited gait disorders may show no abnormalities on examination other than signs implicating the corticospinal tracts. That is the syndrome of "primary lateral sclerosis" (PLS), a clinical diagnosis that has been avoided because it is a diagnosis of exclusion, proven only at autopsy. Now, modern technology can exclude other disorders that can cause the syndrome with an accuracy of about 95%. That serves to eliminate the following: compressive lesions at the foramen magnum or cervical spinal cord, multiple sclerosis, amyotrophic lateral sclerosis, Chiari malformation, syringomyelia, biochemical abnormality, and persistent infection with human immunodeficiency virus or human T-lymphotrophic virus type I. We studied three autopsy-proved cases of PLS; six living patients in whom PLS was diagnosed clinically after comprehensive evaluations that excluded the alternative diagnoses; and two patients with this syndrome of PLS and antibodies to human immunodeficiency virus seropositivity that clinically resembled PLS. Primary lateral sclerosis is now a respectable and permissible diagnosis.

publication date

  • January 1988



  • Academic Article


Digital Object Identifier (DOI)

  • 10.1001/archneur.1988.00520360022005

PubMed ID

  • 3196189

Additional Document Info

start page

  • 1304

end page

  • 7


  • 45


  • 12