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Washington University Experience | INFECTION | Viruses | PML (JC Virus) | PML - Granule Cell Neuronopathy | 2A0 Case 2 History
The patient was a 33 year old female who was diagnosed with AIDS after developing thrush and esophageal candidiasis. On exam she was found to have slightly slowed repetitive movements in her upper extremities. Her lower extremities displayed a mild spastic catch and her gait was markedly ataxic. MRI of the head, cervical and thoracic spine were normal. Her lower extremity ataxia progressed and truncal ataxia developed. Titubation was present as was mild dysarthria. An MRI performed a month later revealed cerebellar atrophy and T2 prolongation in the middle cerebellar peduncles. By the next month her speech was virtually uninterpretable. She developed saccadic intrusions and all movements became ataxic. Her cognitive ability appeared to remain intact for the remainder of her course. She died of aspiration pneumonia, 10 months after the development of her neurologic symptoms. (History and Images of this case were prepared from the virtual slide of the 1993 AANP Diagnostic Slide Session, Case 7)
