PMID- 22136455
OWN - NLM
STAT- MEDLINE
DCOM- 20121119
LR  - 20220408
IS  - 1468-1331 (Electronic)
IS  - 1351-5101 (Linking)
VI  - 19
IP  - 8
DP  - 2012 Aug
TI  - Progressive multifocal leukoencephalopathy: a review of the neuroimaging features 
      and differential diagnosis.
PG  - 1060-9
LID - 10.1111/j.1468-1331.2011.03597.x [doi]
AB  - Progressive multifocal leukoencephalopathy (PML) is an uncommon and often fatal 
      demyelinating disease of human central nervous system, which is caused by 
      reactivation of the polyomavirus JC (JCV). PML generally occurs in patients with 
      profound immunosuppression such as AIDS patients. Recently, a number of PML cases 
      have been associated with administration of natalizumab for treatment of multiple 
      sclerosis (MS) patients. Diagnosis and management of PML became a major concern 
      after its occurrence in multiple sclerosis patients treated with natalizumab. 
      Diagnosis of PML usually rests on neuroimaging in the appropriate clinical 
      context and is further confirmed by cerebrospinal fluid polymerase chain reaction 
      (PCR) for JCV DNA. Treatment with antiretroviral therapies in HIV-seropositive 
      patients or discontinuing natalizumab in MS patients with PML may lead to the 
      development of immune reconstitution inflammatory syndrome (IRIS) which presents 
      with deterioration of the previous symptoms and may lead to death. In patients 
      under treatment with monoclonal antibodies in routine practice, or new ones in 
      ongoing clinical trials, differentiating PML from new MS lesions on brain MRI is 
      critical for both the neurologists and neuroradiologists. In this review, we 
      discuss the clinical features, neuroimaging manifestations of PML, IRIS and 
      neuroimaging clues to differentiate new MS lesions from PML. In addition, various 
      neuroimaging features of PML on the non-conventional MR techniques such as 
      diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and MR 
      spectroscopy (MRS) are discussed.
CI  - (c) 2011 The Author(s). European Journal of Neurology (c) 2011 EFNS.
FAU - Sahraian, M A
AU  - Sahraian MA
AD  - Sina MS Research Center, Brain and Spinal Injury Research Center, Tehran 
      University of Medical Sciences, Tehran, Iran. msahrai@sina.tums.ac.ir
FAU - Radue, E-W
AU  - Radue EW
FAU - Eshaghi, A
AU  - Eshaghi A
FAU - Besliu, S
AU  - Besliu S
FAU - Minagar, A
AU  - Minagar A
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20111205
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
SB  - IM
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis
MH  - Leukoencephalopathy, Progressive Multifocal/*diagnosis
MH  - Multiple Sclerosis/diagnosis
MH  - Neuroimaging/*methods
EDAT- 2011/12/06 06:00
MHDA- 2012/12/10 06:00
CRDT- 2011/12/06 06:00
PHST- 2011/12/06 06:00 [entrez]
PHST- 2011/12/06 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.1111/j.1468-1331.2011.03597.x [doi]
PST - ppublish
SO  - Eur J Neurol. 2012 Aug;19(8):1060-9. doi: 10.1111/j.1468-1331.2011.03597.x. Epub 
      2011 Dec 5.