Progressive Multifocal Leukoencephalopathy Misdiagnosed as a Stroke
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Ger Mullan1,2, Stephen Ramsay3, Michael Jamison4
1Wellcome-Wolfson Institute for Experimental Medicine Queen's University Belfast Belfast UK qub.ac.uk.
Abstract:
Progressive multifocal leukoencephalopathy (PML) is rare and can be challenging to diagnose. Symptoms can be varied and can mimic stroke phenotypes. Physicians must hold a high index of suspicion in patients with significant PML risk factors (including HIV/AIDS, immunosuppression, lymphoproliferative malignancies and chemotherapy/monoclonal antibody therapies) presenting with progressive neurological symptoms. Here, we describe a 63-year-old man who presented with left-sided weakness, apraxia and neglect on a background of subtle cognitive decline. He had a past medical history of recurrent follicular lymphoma with chemotherapy. He was initially diagnosed as a stroke but deteriorated further and ultimately received a diagnosis of PML. Earlier recognition of this condition will help to facilitate research into this disease.
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