Progressive multifocal leukoencephalopathy (PML). A case report and review of literature.

Abstract

Progressive multifocal leukoencephalopathy (PML) is a disease that produces neural demyelination in the central nervous system caused by reactivation of a DNA virus that remains dormant in immunocompetent individuals, known as John Cunningham virus (JCV) occasioned by a prior HIV infection with immunosuppression. We present the case of a 21 years old HIV positive individual with diffuse muscular weakness, dysarthria and severe ataxia and impossibility of maintaining neck and head upward position. Magnetic resonance imagery revealed in the white substance of bilateral cerebellar hemispheres and brainstem extensive T1 hypointense and T2/FLAIR hyperintense lesions, accompanied by discrete water restriction diffusion of water restriction and insignificant contrast substance outlet. Thus, a PML diagnosis was established on radioimagistic grounds.