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Progressive multifocal leukoencephalopathy masquerading as cerebellar infarction

Ruth H Willott1, Wayne Sunman2, Sunil K Munshi3

  • 1Nottingham University Hospitals NHS Trust-Stroke, Nottingham, Nottinghamshire, UK.

Age and Ageing
|April 9, 2016
PubMed

Insights

Progressive multifocal leukoencephalopathy (PML) is a rare brain infection that can occur in immunocompromised patients. Chemotherapy, like Rituximab for lymphoma, can increase the risk of JC virus infection leading to PML.

Area of Science:

  • Neuroscience
  • Immunology
  • Oncology

Background:

  • Immunocompromised individuals are susceptible to opportunistic infections.
  • Progressive neurological deficits can indicate serious underlying conditions.
  • Certain chemotherapies carry risks of specific infections.

Observation:

  • A patient presented with neurological symptoms initially mimicking a posterior circulation stroke.
  • The patient had a history of chemotherapy with Rituximab for lymphoma.

Findings:

  • The patient's condition was diagnosed as progressive multifocal leukoencephalopathy (PML).
  • Rituximab treatment for lymphoma was identified as a predisposing factor for JC virus infection.

Implications:

  • Physicians should consider PML in immunocompromised patients with progressive neurological deficits.
  • Patients undergoing chemotherapy should be informed about the potential risk of PML and JC virus infection.
Keywords:
ataxiabrain infarctionolder peopleposterior circulationprogressive multifocal leukoencephalopathyrituximabstroke

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