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Head tremor and progressive multifocal leukoencephalopathy in AIDS patients: report of two cases

Carlos R M Rieder1, Sofia C Ziomkowski

  • 1Department of Neurology, Hospital de Clínicas, Porto Alegre, RS, Brazil. crieder@logic.com.br

Arquivos De Neuro-Psiquiatria
|April 15, 2005
PubMed

Insights

Progressive multifocal leukoencephalopathy (PML), a brain infection in immunocompromised individuals, rarely causes movement issues. This study reports head tremor as a newly observed symptom in two PML patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurovirology

Background:

  • Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease affecting the central nervous system.
  • It is caused by the JC virus (JCV) reactivating in immunocompromised individuals.
  • Typical PML symptoms include neurological deficits, cognitive impairment, and visual disturbances.

Observation:

  • Movement disorders are uncommon in PML, with reported cases including bradykinesia, rigidity, dystonia, myoclonic jerks, and myoclonic ataxia.
  • Head tremor has not been previously documented as a manifestation of PML.
  • Two immunocompromised patients diagnosed with PML presented with head tremor.

Findings:

  • The presence of head tremor in PML cases suggests a broader spectrum of neurological manifestations.
  • JC virus replication in oligodendrocytes can lead to diverse clinical presentations beyond the typical focal deficits.
  • Head tremor may be an underrecognized sign associated with PML.

Implications:

  • Recognizing head tremor as a potential PML symptom could aid in earlier diagnosis.
  • This finding may prompt further investigation into the neuroanatomical pathways affected by JCV.
  • Understanding the full range of PML symptoms is crucial for patient management and prognosis.

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