Progressive multifocal leukoencephalopathy (PML):
Often seen in AIDS and other immunosuppressive conditions (eg cancer patients; transplant recipients); opportunistic viral (papovavirus JC or SV-40) infection of the oligodendrocytes demyelination of white matter in CNS; in 4-5% of those infected with HIV; in those with HIV, this is initial feature of AIDS in 25%; onset insidious of focal neurological signs (dementia, apraxia, ataxia, blindness); hemiparesis is most common initial feature; progresses to global impairments and death in 3-20 months; no effective treatment (cytosine arabinoside may have marginal benefits).
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