Case Series: Infectious Mimics of Lower Motor Neuron Syndromes – Lessons beyond the Obvious

Background: Lower motor neuron (LMN) syndromes and motor neuropathies are often attributed to autoimmune, genetic, or idiopathic causes. However, infectious etiologies such as leprosy, hepatitis B, and hepatitis C can closely mimic these presentations. Objective: To highlight rare infectious causes of LMN syndromes through three diverse clinical cases. Methods: Retrospective case series of three patients presenting to a neurology department over one year with predominant LMN symptoms. Extensive investigations were performed to rule out autoimmune, metabolic, and genetic causes, eventually revealing infectious origins. Results: The cases were diagnosed as tuberculoid leprosy, occult hepatitis B-associated axonal GBS, and hepatitis C-related motor neuronopathy mimicking MND. Timely antimicrobial therapy led to significant clinical improvement. Conclusion: Neurologists must maintain high clinical suspicion for infectious causes even in chronic or atypical presentations of LMN syndromes.