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Related Concept Videos

Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
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Mouse Models of Periventricular Leukomalacia
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Published on: May 18, 2010

Progressive multifocal leukoencephalopathy.

Thomas Weber1

  • 1Neurologische Klinik, Marienkrankenhaus Hamburg, Academic Teaching Hospital, University of Hamburg, Alfredstr. 9, D-22087 Hamburg, Germany. dr.thomas.weber@hanse.net

Neurologic Clinics
|July 29, 2008
PubMed
Summary
This summary is machine-generated.

Progressive multifocal leukoencephalopathy (PML) incidence has risen due to the AIDS pandemic. Diagnosis involves MRI and JC virus DNA detection, with treatment focused on immune system restoration or cessation of immunosuppression.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Progressive multifocal leukoencephalopathy (PML) incidence has increased fivefold, primarily linked to the AIDS pandemic.
  • PML is an opportunistic infection often associated with HIV infection (85% of cases).
  • Symptoms are diverse, including weakness, speech and visual disturbances, incoordination, and cognitive deficits.

Purpose of the Study:

  • To summarize the incidence, presentation, diagnosis, and treatment of Progressive Multifocal Leukoencephalopathy (PML).

Main Methods:

  • Magnetic Resonance Imaging (MRI) for lesion detection.
  • Cerebrospinal fluid (CSF) analysis via JC viral DNA amplification (spinal tap).

Main Results:

  • MRI reveals T2-hyperintense white matter lesions, sparing subcortical U-fibers; high sensitivity but low specificity.
  • JC viral DNA amplification demonstrates 80% sensitivity and nearly 100% specificity for PML diagnosis.
  • Effective treatment relies on immune reconstitution in HIV patients or withdrawal of immunosuppression in cancer patients.

Conclusions:

  • PML is a significant opportunistic infection in immunocompromised individuals, particularly those with HIV/AIDS.
  • Diagnostic accuracy is high with a combination of neuroimaging and molecular testing.
  • Therapeutic success is contingent upon restoring immune function or reducing immunosuppressive pressure.