Document 0012
 DOCN  M95A0012
 TI    AIDS-associated progressive multifocal leukoencephalopathy revealed by
       new-onset seizures.
 DT    9510
 AU    Moulignier A; Mikol J; Pialoux G; Fenelon G; Gray F; Thiebaut JB;
       Service de Neurologie, Hopital Tenon, Paris, France.
 SO    Am J Med. 1995 Jul;99(1):64-8. Unique Identifier : AIDSLINE MED/95321354
 AB    PURPOSE: To describe the clinical features of new-onset seizures in
       HIV-1-infected persons with progressive multifocal leukoencephalopathy
       (PML), and to discuss potential mechanisms. PATIENTS AND METHODS:
       Forty-nine consecutive HIV-1-infected patients with PML attended our
       institutions between January 1988 and September 1993. We retrospectively
       analyzed cases with seizures as the presenting symptom of PML. RESULTS:
       Twenty percent of the HIV-1-infected patients with PML presented with
       new-onset seizures of various types, generalized or partial. None of
       them met the criteria of the AIDS dementia complex or had a concomitant
       opportunistic infection. Their mean CD4 cell count was < 60/mm3. Brain
       magnetic resonance imaging showed areas of increased signal intensity on
       T2-weighted images in 9 cases, and atrophy in only 1 case. Lesions most
       often involved subcortical white matter in parieto-occipital or frontal
       lobes, but 2 patients had posterior fossa lesions. Image-guided
       stereotactic brain biopsies in 8 cases and postmortem examination in 2
       confirmed the diagnosis of PML. Typical histological lesions were
       observed in all cases, and positive immunolabelling of oligodendroglial
       nuclei was obtained in all cases with the polyclonal antibody directed
       against late SV40 antigens. Putative causative factors for the seizures
       include demyelinated lesions adjacent to the cerebral cortex acting as
       irritative foci, axonal conduction abnormalities, or disturbances of the
       neuron-glia balance. CONCLUSION: These cases illustrate that PML should
       be considered as a possible cause of new-onset seizures in patients with
       HIV-1 infection.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY  Adult  Case
       Report  Epilepsy/PATHOLOGY/*VIROLOGY  Epilepsy, Generalized/VIROLOGY
       Epilepsy, Partial/VIROLOGY  Female  Human  Leukoencephalopathy,
       Progressive Multifocal/*COMPLICATIONS/  PATHOLOGY/VIROLOGY  Male
       Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).