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A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©

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Presentation on theme: "A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©"— Presentation transcript:

1 A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology

2 Vignette A 52-year old man with recently diagnosed HIV infection (CD4 count 105/ µl; normal range 700- 1 200/ µL) presented with 5-week history of irregular shaking of his left hand triggered by lifting his arm accompanied by “feeling of stiffness and clumsiness”. On clinical examination, focal myoclonus with positive and negative components affecting the left upper limb with distal predominance was detected (Video). Katchanov et al. © 2014 American Academy of Neurology

3 Katchanov et al. Imaging © 2014 American Academy of Neurology

4 Focal cortical myoclonus in progressive multifocal leukoencephalopathy Cerebral MRI revealed a demyelinating lesion affecting the juxtacortical white matter of the precentral gyrus (Figure). The CSF PCR for JC-virus was strongly positive confirming the diagnosis of progressive multifocal leucoencephalopathy Katchanov et al. © 2014 American Academy of Neurology

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