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Can PML cause personality change?
Mar 13, 2002

My partner is in the hospital with questionable PML. Is personality change common with this infection only or are there other AIDS related infections that would cause this? He also has lost use of his entire left side. MRI suggests PML but does not rule out Lymphoma or Toxoplasmosis. Should we have a biopsy?

Response from Dr. Dezube

PML stands for progressive multifocal leukoencephalopathy. It's a condition caused by a virus (called the JC virus). PML attacks the cells of the brain causing them not to function. Both personality change and left sided (or right sided) weakness can occur in patients with PML. The best treatment for PML in HIV-infected patients is to treat the underlying HIV infection with potent anti-HIV drugs. Although brain biopsy is the single best way to make the diagnosis, often a presumptive diagnosis can be made by the MRI scan. Lastly, many centers, particularly the teaching hospitals, can test the spinal fluid for the JC virus. If the MRI scan looks like PML and if the spinal fluid is positive for the JC virus, then a brain biopsy is not necessary. However, many centers don't offer the JC virus test on the spinal fluid. I wish your partner luck.


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