Longitudinal Monitoring with Multiple MR Techniques in a Case of Progressive Multifocal Leukoencephalopathy Associated with Multiple Myeloma

Abstract

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the brain caused by the JC virus in immunocompromised patients. We report characteristic features of proton MR spectroscopy, 3-dimensional pseudo-continuous arterial spin labeling imaging, and diffusion tensor imaging in a 53-year-old patient with PML. The utility of multi-modal magnetic resonance techniques for longitudinal monitoring was indicated by their reevaluation over time and consideration of their relation to prognosis.

Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study

“…In tick-born encephalitis, hyperperfusion can be detected in thalamus 15 . Both hypoperfusion and hyperperfusion have been described in progressive multifocal leukoencephalopathy due to John Cunningham virus 9 , 16 . Human immunodeficiency virus encephalopathy is associated with a reduced CBF in frontal and parietal lobes, and in lenticular nuclei 17 .…”

164 Progressive multifocal leukoencephalopathy (PML) following autologous periph- eral blood stem cell transplantation for multiple myeloma

“…24 Developing PML after MM is rare with 11 case reports in the literature. [25][26][27][28][29][30][31][32][33][34][35] Presentations varied in these patients depending on the location of the lesion and included: hemiparesis and hemiplegia, 25,28,29,32,35 numbness and tingling of the legs, 29 rapid cognitive decline, 25,27,33 homonymous hemianopia, 27 ataxia, 27 speech difficulties, 26,[30][31][32]35 incontinence, 26 apathy, 29 and memory impairment. 32-34. Trying to identify if an individual aspect of the MM treatment was responsible for the development of PML is difficult from these isolated case studies.…”

Progressive multifocal leukoencephalopathy in multiple myeloma

“…2,3 The incidence, clinical features, and risk factors for PML in multiple myeloma patients are not firmly established. PML in multiple myeloma patients has been primarily described in sporadic case reports [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] A recent literature review identified 16 cases of PML that met AAN criteria between 1965 and April 2020. 25 Of these, most were published after 2016.…”