Progressive multifocal leukoencephalopathy (PML): investigations
Evidence-based neurology checklist on progressive multifocal leukoencephalopathy (pml): investigations: Magnetic resonance imaging (MRI) lesion features These are subcortical white matter lesions They are multifocal and asymmetric They are hypointense on T1 sequences They appear as high signal on…
Magnetic resonance imaging (MRI) lesion features
- These are subcortical white matter lesions
- They are multifocal and asymmetric
- They are hypointense on T1 sequences
- They appear as high signal on T2 and FLAIR sequences
- They are relatively non-enhancing
- A punctate pattern of lesions is sensitive for Natalizumab PML
Magnetic resonance imaging (MRI) other features
Cerebrospinal fluid (CSF)
Diagnostic criteria for PML
Differential diagnosis from PML-IRIS on MRI
Acronyms
References
- Hunt D, Giovannoni G. Natalizumab-associated progressive multifocal leucoencephalopathy: a practical approach to risk profiling and monitoring. Pract Neurol 2012; 12:25-35.
- Clifford DB, DeLuca A, Simpson DM, Arendt G, Giovannoni G, Nath A. Natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: lessons from 28 cases. Lancet Neurol 2010; 9:438-446.
- Warnke C, Menge T, Hartung H-P, et al. Natalizumab and progressive multifocal leukoencephalopathy. Arch Neurol 2010; 67:923-930.McGuigan C, Craner M, Guadagno J, et al. Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group. JNNP 2016; 87:117-125.
- Wattjes MP, Wijburg MT, Vennegoor A, et al; Dutch-Belgian Natalizumab-associated PML study group. MRI characteristics of early PML-IRIS after natalizumab treatment in patients with MS. JNNP 2016; 87:879-884.
- Hodel J, Darchis C, Outteryck O, et al. Punctate pattern: a promising imaging marker for the diagnosis of natalizumab-associated PML. Neurology 2016; 86:1516-1523.
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