Department of Neurology, University Medical Center Regensburg, Germany.
Mult Scler. 2010 Jun;16(6):749-53. doi: 10.1177/1352458510367718. Epub 2010 May 7.
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.
进行性多灶性白质脑病在那他珠单抗治疗多发性硬化症患者中日益受到关注。在此，我们描述了 1 例 35 岁患者，在出现视力下降前已接受 34 次那他珠单抗治疗。MRI 无诊断意义，JC 病毒检测最初为阴性。脑电图显示右半球严重减慢，神经心理学测试显示右额叶和颞叶缺陷。2 个月后，典型 MRI 表现和脑脊液中 JC 病毒 DNA 的检测确立了进行性多灶性白质脑病的诊断。神经功能缺损可能先于影像学表现出现，应促使早期考虑进行性多灶性白质脑病。
