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Abstract
Progressive multifocal leukoencephalopathy (PML) presents in the setting of a poor immunological status expressed by a low CD4 cell count (< 200/µL). Very few reports have described of PML in HIV-infected patients in the setting of better immunological function (i.e. CD4 counts >500/µL).1 PML can occur in setting of CD4 Count more than 200 reason being high CSF viral load and ART failure. Although seizures have been considered a rare manifestation of PML, seizures can occur in up to 18% of PML patients2. In minority of patients PML can actually be revealed by new onset seizures. Seizures usually respond well to treatment and do not affect survival. Very rarely patient can present as resistant status epilepticus3 or epilepsia partialis continua4. we present a case were PML is manifested as super refractory status epilepticus in a patient with CD count >200 /µl.
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References
- Delobel P, Brassat D, Delisle MB, Scaravilli F, Clanet M. Progressive multifocal leukoencephalopathy in an HIV patient with normal CD4 T-cell count and magnetic resonance imaging. AIDS. Mar 5 2004;18(4):702-4
- Lima MA, Drislane FW, Koralnik IJ. Seizures and their outcome in progressive multifocal leukoencephalopathy. Neurology. Jan 24 2006;66(2):262-4
- R.Y.L. Tan, A. Neligan, S.D. Shorvon The uncommon causes of status epilepticus: A Systematic ReviewEpilepsy Research (2010) 91, 111—122
- Ferrari, S., Monaco, S., Morbin, M., Zanusso, G., Bertolasi, L., Cerini, R., Rizzuto, N., 1998. HIV-associated PML presenting as epilepsia partialis continua. J. Neurol. Sci. 161, 180—184.
- Simon Shorvon and Monica Ferlisi The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol Brain 2011.
References
Delobel P, Brassat D, Delisle MB, Scaravilli F, Clanet M. Progressive multifocal leukoencephalopathy in an HIV patient with normal CD4 T-cell count and magnetic resonance imaging. AIDS. Mar 5 2004;18(4):702-4
Lima MA, Drislane FW, Koralnik IJ. Seizures and their outcome in progressive multifocal leukoencephalopathy. Neurology. Jan 24 2006;66(2):262-4
R.Y.L. Tan, A. Neligan, S.D. Shorvon The uncommon causes of status epilepticus: A Systematic ReviewEpilepsy Research (2010) 91, 111—122
Ferrari, S., Monaco, S., Morbin, M., Zanusso, G., Bertolasi, L., Cerini, R., Rizzuto, N., 1998. HIV-associated PML presenting as epilepsia partialis continua. J. Neurol. Sci. 161, 180—184.
Simon Shorvon and Monica Ferlisi The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol Brain 2011.