Demyelinative process associated with atypical intranuclear glial inclusions

This case study documents a demyelinating process associated with atypical glial intranuclear inclusions. The patient, a 38-year-old woman, presented with acute onset of headaches and weakness. Magnetic resonance imaging revealed two discrete intrahemispheric lesions. Light microscopic examination showed small, homogeneous, eosinophilic inclusions chiefly in astroglial nuclei. By electron microscopy these inclusions were shown to be clusters of filamentous structures. Attempts to identify the particles with an antibody to measles virus and in situ hybridization to JC virus were negative. The morphologic appearance of the inclusions in this case is similar to that described in neuronal intranuclear inclusion disease.