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PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML)

Neurology

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML)

1. It is typically seen in patients with T-cell immune defects (HIV/AIDS, chronic steroids, monoclonal antibodies), chronic neoplastic diseases.

2. Also A/W immunosuppressants for treatment of rheumatologic, hematologic, and IBD (rituximab, fludarabine, mycophenolate, chronic corticosteroids)

3. PML is caused by the human JC polyomavirus, resulting in a progressive demyelination of the CNS white matter.

4. Symptoms - personality changes and intellectual impairment, slurred speech.

5. Initial symptoms followed by hemiparesis progressing to quadriparesis, visual field defects, cortical blindness, aphasia, ataxia, dysarthria, dementia, confusional states, and/or coma. Some have predominantly cerebellar syndrome.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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