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PML and medications

May 10, 2011

i do not know weather i am posting the question in the right segment but it was the only place which i could find to post my question i was diagnosed hiv+ive in 2008 with severe neurological complication PML. immediately i started on antiretrovirals. after 5 months i started getting frequent seizures. i consulted a neurologist and he asked me to take 500mg levera 3 times a day. i also consulted a hiv expert and he said that the seizures would subside as cd4 would increase. the seizures subsided after 1 year even after i continued to take levera and frisium. it subsided when my cd4 reached 500 but my neurologist insisted that i should continue it as the seizures may restart. i stopped taking levera 8 months back and had no problem of seizures even after stopping it. i again went to neurologist and told him that the hiv expert has told me that the seizures are related to cd4 count but he did not agreed to it and asked me to get an mri done again to see weather the frontal lesions responsible for seizures have disappeared or not. i want to know that do the destroyed myelin producing cells of cortical region are formed again in the course of time. should i start taking levera again? i am confused as to what to do? plz help me.

Response from Dr. Frascino


I would follow the advice of the neurologist. Get the MRI and restart the anti-seizure medication. Also, ask your neurologist to speak directly with your HIV physician specialist. You shouldn't be caught between two conflicting medical opinions. The neurologist and the HIV specialist should discuss your specific situation and devise a treatment recommendation they both concur with.

You can read more about PML in the archives of this forum and elsewhere on this site.

Good luck.

Dr. Bob


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