Early changes on electroencephalography in natalizumab-associated progressive multifocal leucoencephalopathy.
Progressive multifocal leucoencephalopathy has become a growing concern in natalizumab-treated multiple sclerosis patients. Here, we describe a 35-year-old patient who was treated with 34 infusions of natalizumab before complaining about visual deterioration. MRI was non-diagnostic and JC virus testing initially was negative. Electroencephalography showed severe slowing of the right hemisphere, and neuropsychological testing revealed right frontal and temporal deficits. The diagnosis of progressive multifocal leucoencephalopathy was established 2 months later by typical MRI presentation and detection of JC virus DNA in the cerebrospinal fluid. Functional neurological deficits may precede imaging features and should prompt early consideration of progressive multifocal leucoencephalopathy.
Kleiter
Ingo
I
Department of Neurology, University Medical Center Regensburg, Germany. ingo.kleiter@klinik.uni-regensburg.de
Schröder
Michael
M
Lürding
Ralf
R
Schuierer
Gerhard
G
Clifford
David B
DB
Bogdahn
Ulrich
U
Steinbrecher
Andreas
A
Pöschl
Peter
P
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D001921:Brain / Q000473:pathology / Q000821:virology; D001931:Brain Mapping; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007577:JC Virus / Q000235:genetics*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000473:pathology / Q000821:virology*; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000473:pathology / Q000628:therapy* / Q000821:virology; D000069442:Natalizumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab