Progressive Multifocal Leucoencephalopathy in Patient with CLL

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J Neurol Neurosurg Psychiatry. 2007 Apr;78(4):408-10.

Reversible parkinsonism in a patient with progressive multifocal

leucoencephalopathy.

-Gray CH, Aliyu SH, Lever AM, Dean AF, Lennox GG.

Department of Clinical Neurosciences, University of Cambridge and

Addenbrooke's Hospital, Cambridge, UK. chm27@...

A case of pathologically confirmed progressive multifocal

leucoencephalopathy presenting with unilateral parkinsonism and

cognitive decline that significantly improved over a 12-month period

without any treatment is described.

The patient had a background of chronic lymphocytic leukaemia, but

had been in complete remission for 4 years at the time of diagnosis.

This case is highly unusual not only in terms of the mode of

clinical presentation in an apparently immunocompetent patient but

also in that the patient spontaneously improved without any

intervention.

Progressive multifocal leucoencephalopathy should therefore be

considered in the differential diagnosis of movement disorders

developing in patients with a history of lymphoproliferative

disease, even if they are in remission.

Furthermore, such cases may not always require treatment, as the

patient's immune system may overcome the viral disease process with

spontaneous resolution of their neurological disorder.

PMID: 17369594 [PubMed - in process]