Progressive multifocal leukoencephalopathy

Alternative Names: PML

Progressive multifocal leukoencephalopathy (PML) is a rare disorder that damages the material (myelin) that covers and protects nerves in the white matter of the brain.

Causes of Progressive multifocal leukoencephalopathy

The JC virus (JCV) causes PML. By age 10, most people have been infected with this virus, but it hardly ever causes symptoms.

Anyone with a weakened immune system, however, are at greater risk of developing PML. Causes of a weakened immune system include:

• AIDS (less common now because of better AIDS treatments)
• Certain medications used to treat multiple sclerosis, rheumatoid arthritis, and related conditions
• Leukemia and lymphoma

Progressive multifocal leukoencephalopathy Symptoms

• Headaches
• Loss of coordination, clumsiness
• Loss of language ability (aphasia)
• Memory loss
• Vision problems
• Weakness of the legs and arms that gets worse

Tests and Exams

Tests may include:

• Brain biopsy (rare)
• Cerebrospinal fluid test for the JCV
• CT scan of the brain
• Electroencephalogram (EEG)
• MRI of the brain

Treatment of Progressive multifocal leukoencephalopathy

In people with AIDS, treatment to strengthen the immune system can lead to recovery from the symptoms of PML. No other treatments have proved effective for PML.

Prognosis (Outlook)

PML is a life-threatening condition. Talk to your doctor about care decisions.

Boren EJ, Cheema GS, et al. The emergence of progressive multifocal leukoencephaloparhy (PML) in rheumatic diseases. J Autoimmun. 2008;30(1-2):90-98.

Gray and white matter of the brain	Leukoencephalopathy

Review Date: 2/6/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, CA, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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