How is leukoencephalopathy diagnosed?
A diagnosis of PML can be made following brain biopsy or by combining observations of a progressive course of the disease, consistent white matter lesions visible on a magnetic resonance imaging (MRI) scan, and the detection of the JC virus in spinal fluid.
What viruses cause leukoencephalopathy?
Progressive multifocal leukoencephalopathy results from infection by the JC virus. The JC virus is often acquired during childhood. Most adults have been infected with the JC virus but do not develop the disorder.
Can an MRI detect PML?
MRI has been able to detect PML-related changes 3 to 4 months before development of symptoms. Because prompt detection and treatment of PML in the presymptomatic phase has been shown to improve outcomes, appropriate surveillance of patients taking natalizumab is essential.
How is leukoencephalopathy treated?
Treatment for PML focuses on strengthening your immune system. For example, if you have AIDS, you may take antiretroviral therapy (drugs to reduce HIV in your body). This treatment can restore some of your immune system’s function. Other people may benefit from plasma exchange.
Does PML show on CT scan?
CT of the brain in PML reveals hypodense lesions of the affected white matter. On CT scan, the lesions of PML exhibit no mass effect and infrequently contrast enhance. A “scalloped” appearance beneath the cortex is noted when there is involvement of the subcortical arcuate fibers.
What does PML look like on MRI?
The PML findings on brain MRI scans are described as bilateral, asymmetric subcortical-predominant lesions that appear hyperintense on T2-weighted and FLAIR sequences and hypointense on T1-weighted sequences. Mass effect is typically absent or mild, but not invariably.
What is toxic leukoencephalopathy?
Toxic leukoencephalopathy (TL) is a disorder of brain white matter caused by exposure to leukotoxic agents. Magnetic resonance imaging (MRI) can readily identify this syndrome, and, together with diffusion tensor imaging, MRI continues to offer important insights into its nature.
What are rare brain infections?
Encephalitis is an uncommon but serious condition in which the brain becomes inflamed (swollen). It can be life threatening and requires urgent treatment in hospital. Anyone can be affected, but the very young and very old are most at risk.
Can white matter on brain go away?
White matter disease doesn’t have a cure, but there are treatments that can help manage your symptoms. The primary treatment is physical therapy. Physical therapy can help with any balance and walking difficulties you may develop.
How is leukodystrophy treated?
- Treatment for most types of leukodystrophy is symptomatic and supportive, and may include:
- Medications can be used to manage muscle tone, seizures, and spasticity.
- Stem cell or bone marrow transplantation is showing promise for a few types of leukodystrophy.
- One of the leukodystrophies is now a treatable disease.
Can MS be mistaken for PML?
The diagnosis of PML in MS patients is particularly challenging, since they are both demyelinating diseases. Consequently, the presentation of PML can overlap with RRMS, and symptoms can be mistaken for flares of MS disease activity, which makes patient history is an important aspect of the diagnosis.
How is the diagnosis of leukoencephalopathy made?
Diagnosis of leukoencephalopathy. It is important to remember that abnormalities or ophthalmological changes are very frequent in leukoencephalopathy. It is also necessary a neurological examination to detect the existence of spasticity or excessive muscular tension, being able to also occur hypotonía (the opposite).
How is progressive multifocal leukoencephalopathy (PFL) diagnosed?
Under certain conditions, such as progressive multifocal leukoencephalopathy, an analysis of the cerebrospinal fluid may be performed. The technique is called PCR (Polymerase Chain Reaction), and is performed to detect the JC virus; Which is the cause of this disease.
Toxic leukoencephalopathy is an encephalopathy predominantly affecting white matter as a result of a toxic substance. The presentation can either be chronic or acute.
Are CADASIL phenocopies associated with vascular leukoencephalopathy?
We describe a CADASIL family in which two members suffering from a vascular leukoencephalopathy were shown to be CADASIL phenocopies: clinical and magnetic resonance imaging (MRI) findings in these two patients were similar to those observed in their affected relatives.