title: Akinetic mutism caused by HIV-associated progressive multifocal leukoencephalopathy was successfully treated with mefloquine: a serial multimodal MRI Study.
abstract: We report a case of a patient with highly active anti-retroviral therapy-resistant human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML). The patient showed an improvement in imaging findings and clinical symptoms after mefloquine was introduced as an additional treatment. Serial assessment of white matter lesions was conducted by proton magnetic resonance spectroscopy ((1)H-MRS) and diffusion-weighted imaging (DWI). As the clinical symptoms improved, the N-acetylaspartate/creatine ratio increased, the choline/creatine ratio decreased, and the elevated ADC value decreased. These concomitant changes suggested that (1)H-MRS and DWI were useful for the assessment of the therapeutic effect on PML.
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Japan.
authors.forename: Kasane
authors.initials: K
authors.lastname: Naito
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ueno
authors.forename: Mayu
authors.initials: M
authors.lastname: Sekine
authors.forename: Munekazu
authors.initials: M
authors.lastname: Kanemitsu
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ohshita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Takemori
authors.initials: T
authors.lastname: Yamawaki
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000405:Akinetic Mutism / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D015767:Mefloquine