Related Experiment Video
Updated: May 27, 2026
06:24
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
The clinical features of PML
1Department of Neurology, University of Kentucky Medical Center, KY Clinic (Wing D) - L445, Lexington, KY 40536-0284, USA. jrbneuro@email.uky.edu
Cleveland Clinic Journal of Medicine
|November 30, 2011
Summary
Progressive multifocal leukoencephalopathy (PML) symptoms vary by lesion location. Diagnosis relies on JC virus detection, clinical signs, and MRI, with improved prognosis due to immune reconstitution.
Area of Science:
- Neurology
- Infectious Diseases
- Oncology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, demyelinating disease of the central nervous system.
- PML is caused by the John Cunningham virus (JCV).
- PML is often associated with conditions that weaken the immune system, such as acquired immunodeficiency syndrome (AIDS) and certain immunosuppressive therapies.
Purpose of the Study:
- To describe the clinical presentation, diagnosis, and prognosis of PML.
- To highlight the increasing association of PML with biologic agents, specifically natalizumab.
- To discuss the diagnostic methods and the impact of immune reconstitution on patient outcomes.
Main Methods:
- Review of clinical data and diagnostic findings in PML patients.
- Detection of JCV DNA in cerebrospinal fluid (CSF) via polymerase chain reaction (PCR).
- Magnetic resonance imaging (MRI) to identify PML brain lesions.
Main Results:
- PML symptoms correlate with the location of brain lesions, including visual, cognitive, and motor deficits.
- Natalizumab, a biologic agent, is now a leading cause of PML, second only to AIDS.
- Diagnosis typically involves a combination of clinical presentation, CSF JCV PCR, and MRI findings.
Conclusions:
- While brain biopsy is definitive, non-invasive methods are now standard for PML diagnosis.
- Immune reconstitution has significantly improved the prognosis for patients with PML.
- Increased awareness of PML in patients receiving immunosuppressive therapies is crucial.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
01:27Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
01:19Multiple Sclerosis l: Introduction
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...
01:26Encephalitis 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...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...