TY  - BOOK
AU  - Bachman, David M
AU  - Mark, Alexander S
TI  - Progressive Multifocal Leukoencephalopathy: Recent Advances and a Neuro-Ophthalmological Review. [Review]
SN  - 1070-8022
PY  - 2015///
KW  - *Leukoencephalopathy, Progressive Multifocal/di [Diagnosis]
KW  - *Leukoencephalopathy, Progressive Multifocal/th [Therapy]
KW  - *Neurology/mt [Methods]
KW  - *Ophthalmology/mt [Methods]
KW  - Adult
KW  - Brain
KW  - Female
KW  - Humans
KW  - Leukoencephalopathy, Progressive Multifocal/ep [Epidemiology]
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Middle Aged
KW  - Visual Pathways/pa [Pathology]
KW  - MedStar Washington Hospital Center
KW  - Ophthalmology
KW  - Radiology
KW  - Case Reports
KW  - Journal Article
KW  - Review
N1  - Available online from MWHC library: 2001 - present, Available in print through MWHC library: 1998 - 2006
N2  - BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a severe often fatal opportunistic infection of the central nervous system caused by reactivation of a ubiquitous polyoma virus, JC virus. Although typically characterized by multifocal asymmetric subcortical white matter lesions, it may be monofocal and affect the cortical gray matter. Among the broad spectrum of clinical manifestations that occurs with PML, visual complaints are common; CONCLUSIONS: Visual complaints occur in patients with PML and are often the presenting sign. Awareness of this condition is helpful in avoiding unnecessary delays in the diagnosis of PML and management of the underlying condition. Recent guidelines have established criteria for diagnosis of PML in the high-risk patient population and strategies to mitigate the risk in these populations; EVIDENCE ACQUISITION: Combination of representative personally observed cases of PML and comprehensive review of case series of PML from 1958 through 2014; RESULTS: Neuro-ophthalmic signs and symptoms were reported in approximately 20%-50% of patients with PML and can be the presenting manifestation in half of these. A majority of these presentations occur from damage to cerebral visual pathways resulting in visual field defects, cortical blindness, and other disorders of visual association. Given the decreased frequency of infratentorial and cerebellar involvement, ocular motility disorders are less common
UR  - http://dx.doi.org/10.1097/WNO.0000000000000271
ER  -