Progressive multifocal leukoencephalopathy

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This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see JC virus.

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Progressive multifocal leucoencephalopathy, Multifocal leucoencephalopathy, Multifocal leukoencephalopathy, PML, PMLE

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Progressive multifocal leukoencephalopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Patients with Progressive Multifocal leukoencephalopathy(PML) have a long-term neurological sequelae and is often fatal. The mortality rate is 30%-50% [1] in early months of diagnosis. Those who are immunocompromised are at significant risk of reactivation.

COMPLICATIONS

PML may complicate into the following :

  • Neurologic Dysfunction
  • Dementia
  • Blindness
  • Seizures
PROGNOSIS
  • The prognosis is variable and depends on the underlying severity of PML.
  • Impairment of immune system (eg. HIV) or use of immunosuppressants may worsen prognosis and leads to rapid progression of the disease.[1]
  • Patients who survive have substantial morbidity and severe neurological disabilities.[2]

Reference

  1. Progressive Multifocal Leukoencephalopathy Information Page. NIH-National Institute of Neurological Disorders and Stroke. 29 July 2019. Retrieved 12 June 2021.
  2. Castle, D., & Robertson, N. P. (2019). Treatment of progressive multifocal leukoencephalopathy. Journal of Neurology, 266(10), 2587–2589. https://doi.org/10.1007/s00415-019-09501-y

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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