185:(JCV), after the initials of the person (John Cunningham) from whose tissue the virus was first successfully cultured. Publications indicate 39 to 58% of the general population are seropositive for antibodies to JCV, indicating current or previous infection with the virus. Other publications put the percentage at 70 to 90% of the general population. JCV causes persistent asymptomatic infection in about one-third of the adult population, based on viral shedding into the urine from the site of asymptomatic infection in the kidney. The virus causes disease only when the immune system has been severely weakened.
56:
32:
227:. After a safety review, the drug was returned to the market in 2006 as a monotherapy for MS under a special prescription program. As of May 2011, over 130 cases of PML had been reported in MS patients, all in patients who had taken natalizumab for more than a year. While none of them had taken the drug in combination with other disease-modifying treatments, previous use of MS treatments increases the risk of PML between three- and four-fold. The estimated
396:(1-O-hexadecyloxypropyl-cidofovir /CMX001) available as Tembexa, suppresses JCV, but has been found to have toxicity at therapeutic dosage. Infusion of donor T cells specific to the related BK polyomavirus has shown possible effect in treating PML in one small study by Katy Rezvani's group, but needs further study. In December 2021, Cellevolve announced it is launching a clinical trial for the treatment of PML utilizing BK virus specific T-cells (VSTs).
197:, as many as 5% of people with AIDS eventually developed PML. Why PML occurs more frequently in people with AIDS than in other immunosuppressive conditions is unclear; some research suggests the effects of HIV on brain tissue, or on JCV itself, make JCV more likely to become active in the brain and increase its damaging inflammatory effects.
803:
Christian; Vass, Karl; Clifford, David B; Hauser, Stephen; Major, Eugene O; O'Connor, Paul W; Weiner, Howard L; Clanet, Michel; Gold, Ralf; Hirsch, Hans H; Radü, Ernst-Wilhelm; Sørensen, Per
Soelberg; King, John (August 2011). "Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring".
1599:
369:(also known as ARA-C), a chemotherapy drug used to treat certain cancers, has been prescribed on an experimental basis for a small number of non-AIDS PML patients, and stabilized the neurological condition of a minority of these patients. One patient regained some cognitive function lost as a result of PML.
353:(HAART). AIDS patients starting HAART after being diagnosed with PML tend to have a slightly longer survival time than patients who were already on HAART and then develop PML. Some AIDS patients with PML have been able to survive for several years, with HAART. A rare complication of effective HAART is
108:, which is normally present and kept under control by the immune system. The JC virus is harmless except in cases of weakened immune systems. In general, PML has a mortality rate of 30–50% in the first few months, and those who survive can be left with varying degrees of neurological disabilities.
802:
Kappos, Ludwig; Bates, David; Edan, Gilles; Eraksoy, Mefkûre; Garcia-Merino, Antonio; Grigoriadis, Nikolaos; Hartung, Hans-Peter; Havrdová, Eva; Hillert, Jan; Hohlfeld, Reinhard; Kremenchutzky, Marcelo; Lyon-Caen, Olivier; Miller, Ariel; Pozzilli, Carlo; Ravnborg, Mads; Saida, Takahiko; Sindic,
345:
No drugs effectively inhibit or cure the virus infection without toxicity. Therefore, treatment aims at reversing the immune deficiency to slow or stop the disease progress. In patients on immunosuppression, this means stopping the drugs or using plasma exchange to accelerate the removal of the
246:
by the FDA for MS. In 2015, the first case of PML and a case of "probable PML" were reported by two
Gilenya users that could not be tied to previous immunosuppressant therapies. These new cases are now being added to the drug information sheet included with every prescription (i.e. the "drug
1068:
Vendrely, Aurélie; Bienvenu, Boris; Gasnault, Jacques; Thiebault, Jean
Baptiste; Salmon, Dominique; Gray, Françoise (April 2005). "Fulminant inflammatory leukoencephalopathy associated with HAART-induced immune restoration in AIDS-related progressive multifocal leukoencephalopathy".
1024:
Gray, Françoise; Salmon, Dominique; Thiebault, Jean
Baptiste; Gasnault, Jacques; Bienvenu, Boris; Vendrely, Aurélie (2005). "Fulminant inflammatory leukoencephalopathy associated with HAART-induced immune restoration in AIDS-related progressive multifocal leukoencephalopathy".
151:
Symptoms can develop over several weeks to months, and they depend on location of damage in the brain and the degree of damage. The most prominent symptoms are "clumsiness, progressive weakness, and visual, speech, and sometimes personality changes". The lesions affecting the
974:
Wyen, Christoph; Hoffmann, Christian; Schmeier, Norbert; Hoffmann, Andrej; Qurishi, Nazifa; Rockstroh, Jürgen; Esser, Stefan; Rieke, Ansgar; Ross, Birgit; Lorenzen, Thore; Schmitz, Karina; Stenzel, Werner; Salzberger, Bernd; Fätkenheuer, Gerd (2004).
1707:
1692:
1677:
1290:
Buckanovich RJ1, Liu G, Stricker C; et al. (July 2002). "Nonmyeloablative allogeneic stem cell transplantation for refractory
Hodgkin's lymphoma complicated by interleukin-2 responsive progressive multifocal leukoencephalopathy".
745:
Berger, Joseph (2003). "Progressive multifocal leukoencephalopathy in acquired immunodeficiency syndrome: explaining the high incidence and disproportionate frequency of the illness relative to other immunosuppressive conditions".
1600:"Cellevolve Announces Global Partnership with QIMR Berghofer Medical Research Institute to Advance Novel Off-the Shelf T-cell Therapy in the First Randomized Cell Therapy Trial for Progressive Multifocal Leukoencephalopathy (PML)"
404:
One-third to one-half of people with PML die in the first few months following diagnosis, depending on the severity of their underlying disease. Survivors can be left with variable degrees of neurological disability.
231:
of PML in MS is 1.5 cases per thousand natalizumab users. Around 20% of MS patients with PML die, and most of the rest are very disabled. One case study describes an MS patient who, during a 4-year course of
3281:
3667:
3662:
357:(IRIS), in which increased immune system activity actually increases the damage caused by the JCV infection; although IRIS can often be managed with medication, it is extremely dangerous in PML.
267:
of nerve cells is gradually destroyed, impairing the transmission of nerve impulses. It affects the subcortical white matter, particularly that of the parietal and occipital lobes. PML destroys
3679:
3657:
299:
is diagnostic when the typical histopathology of demyelination, bizarre astrocytes, and enlarged oligodendroglial nuclei are present, coupled with techniques showing the presence of JC virus.
2395:
2830:
219:(Tysabri) was approved in 2004 by the FDA for the treatment of multiple sclerosis (MS). It supposedly works by preventing white blood cells from entering the brain. It was subsequently
3753:
869:"FDA Drug Safety Communication: FDA warns about cases of rare brain infection with MS drug Gilenya (fingolimod) in two patients with no prior exposure to immunosuppressant drugs"
275:
inclusions. It is similar to another demyelinating disease, MS, but progresses much more quickly. The breakdown of myelin is proportional to the degree of immunocompromise.
1818:
3026:
1334:
1352:
Jamilloux, Y; Kerever, S; Ferry, T; Broussolle, C; Honnorat, J; Sève, P (October 2016). "Treatment of
Progressive Multifocal Leukoencephalopathy With Mirtazapine".
1338:
424:
337:
structures such as the brain stem and cerebellum. Although typically multifocal, natalizumab-associated PML is often monofocal, predominantly in the frontal lobe.
3021:
2409:
1397:"Molecular biology, epidemiology, and pathogenesis of progressive multifocal leukoencephalopathy, the JC virus-induced demyelinating disease of the human brain"
854:
2823:
354:
1906:
3649:
1946:
594:
Egli, Adrian; Infanti, Laura; Dumoulin, Alexis; Buser, Andreas; Samaridis, Jacqueline; Stebler, Christine; Gosert, Rainer; Hirsch, Hans H. (2009).
3639:
2816:
468:
3619:
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3644:
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1811:
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with activity against the JC virus. The patient cleared the virus and had no further neurological deterioration. Two case reports of using
2096:
116:
3701:
3634:
3189:
223:
by its manufacturer after it was linked with three cases of PML. All three initial cases were taking natalizumab in combination with
3768:
3404:
3207:
2415:
1941:
1898:
2330:
977:"Progressive multifocal leukencephalopathy in patients on highly active antiretroviral therapy: survival and risk factors of death"
2401:
1804:
3523:
3038:
3014:
2844:
2000:
1986:
1495:"CMX001 (1-O-Hexadecyloxypropyl-Cidofovir) Inhibits Polyomavirus JC Replication in Human Brain Progenitor-Derived Astrocytes"
1446:"CMX001 (1-O-hexadecyloxypropyl-cidofovir) inhibits polyomavirus JC replication in human brain progenitor-derived astrocytes"
3230:
1628:
3717:
3602:
3518:
3460:
3009:
1159:
Aksamit, A J (August 2001). "Treatment of non-AIDS progressive multifocal leukoencephalopathy with cytosine arabinoside".
3763:
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3060:
2205:
2199:
2110:
2104:
1994:
31:
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2568:
2494:
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894:
414:
363:
was studied as possible treatment for PML and has been used on a case-by-case basis, working in some, but not others.
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292:
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3624:
3592:
3544:
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2232:
429:
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3465:
2879:
2334:
2246:
2151:
1981:
1954:
1926:
1859:
1722:
3696:
314:, but MRI is far more sensitive than CT. The most common area of involvement is the cortical white matter of
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3385:
3203:
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2130:
439:
334:
220:
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2156:
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Langer-Gould, Annette; Atlas, Scott W.; Green, Ari J.; Bollen, Andrew W.; Pelletier, Daniel (July 2005).
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2240:
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388:, but this has not been demonstrated in clinical trials. A number of drugs work against JC virus in
3442:
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350:
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55:
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1006:
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543:
Kean, Jaime M.; Rao, Suchitra; Wang, Michael; Garcea, Robert L. (2009). Atwood, Walter J. (ed.).
224:
132:
2808:
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1395:
Ferenczy, MW; Marshall, LJ; Nelson, CD; Atwood, WJ; Nath, A; Khalili, K; Major, EO (July 2012).
3375:
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1308:
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1086:
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855:"Dimethyl fumarate (Tecfidera): Fatal PML in an MS patient with severe, prolonged lymphopenia"
828:
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44:
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895:"Progressive multifocal leukoencephalopathy | Radiology Reference Article | Radiopaedia.org"
820:
812:
753:
717:
701:
660:
652:
607:
596:"Prevalence of Polyomavirus BK and JC Infection and Replication in 400 Healthy Blood Donors"
566:
556:
515:
507:
330:
927:"PML diagnostic criteria: consensus statement from the AAN Neuroinfectious Disease Section"
3420:
3111:
2657:
2585:
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2562:
2482:
2471:
2342:
2306:
2226:
2012:
1873:
268:
690:"Progressive multifocal leukoencephalopathy and the spectrum of JC virus-related disease"
283:
PML is diagnosed in a patient with a progressive course of the disease, finding JC virus
1493:
Rainer, Gosert; Rinaldo, Christine; Wernli, Marion; Major, Eugene; Hirsch, Hans (2011).
1243:
Gofton, T. E.; Al-Khotani, A.; O'Farrell, B.; Ang, L. C.; McLachlan, R. S. (June 2010).
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3455:
3325:
3094:
3050:
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1831:
1544:"Allogeneic BK Virus–Specific T Cells for Progressive Multifocal Leukoencephalopathy"
868:
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381:
326:
319:
153:
1773:
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840:
773:
2999:
2869:
2852:
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2138:
511:
434:
389:
315:
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PML is most common in people with HIV1 infection; prior to the advent of effective
178:
124:
85:
81:
1654:
1204:"Progressive multifocal leukoencephalopathy in a patient treated with natalizumab"
1727:
942:
561:
2958:
2919:
2861:
2789:
2738:
2726:
2721:
2714:
2702:
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2676:
2646:
2548:
2387:
2299:
2282:
2217:
1878:
1757:
1649:
385:
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appeared of a PML patient being successfully treated with the antimalarial drug
373:
216:
93:
1738:
1638:
705:
3069:
2939:
2639:
2423:
2180:
1701:
1365:
1304:
1172:
1082:
1038:
757:
377:
366:
239:
228:
205:
201:
1567:
1260:
713:
243:
208:, and various transplant drugs, which are meant to weaken the immune system.
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2614:
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2353:
2315:
2084:
2063:
1969:
1847:
1839:
1827:
1768:
1643:
1542:
Muftuoglu, Muharrem; Olson, Amanda; Marin, David; et al. (2018-10-11).
494:
Panikkath, Ragesh; Panikkath, Deepa; Mojumder, Deb; Nugent, Kenneth (2014).
360:
136:
49:
1585:
1528:
1479:
1430:
1373:
1312:
1268:
1245:"Mefloquine in the treatment of progressive multifocal leukoencephalopathy"
1229:
1180:
1137:
1090:
1046:
1002:
960:
832:
765:
731:
674:
621:
580:
529:
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2027:
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1510:
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1412:
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824:
656:
182:
105:
2535:
1444:
Gosert, R; Rinaldo, C.H.; Wernil, M; Major, EO; Hirsch, HH (May 2011).
384:
successfully have been published. Some success have been reported with
303:
1669:
1129:
127:
are also at increased risk of PML, such as patients with transplants,
3398:
3139:
3106:
2144:
1696:
1681:
296:
260:
392:, but no proven, effective therapy is known in humans. For example,
200:
PML can still occur in people on immunosuppressive therapy, such as
3654:
Spinal muscular atrophy with lower extremity predominance (SMALED)
612:
595:
2795:
2554:
2186:
194:
73:
39:
T2-weighted MRI showing progressive multifocal leukoencephalopathy
1114:"Use of cidofovir in progressive multifocal leukoencephalopathy"
925:
Berger JR; Aksamit AJ; Clifford DB; et al. (9 April 2013).
688:
Cortese, Irene; Reich, Daniel S.; Nath, Avindra (January 2021).
264:
2812:
1800:
641:"JC Virus evolution and its association with human populations"
2021:
1632:
284:
469:"Progressive Multifocal Leukoencephalopathy Information Page"
325:, but lesions may occur anywhere in the brain, such as the
1112:
Segarra-Newnham, Marisel; Vodolo, Kristen M (June 2001).
473:
National
Institute of Neurological Disorders and Stroke
291:
together with consistent white-matter lesions on brain
111:
PML occurs almost exclusively in patients with severe
160:
lobes of the brain can lead to a phenomenon known as
1659:
346:
biologic agent that put the person at risk for PML.
3575:
3552:
3543:
3536:
3491:
3441:
3413:
3384:
3350:
3312:
3301:
3267:
3245:
3170:
2980:
2971:
2957:
2917:
2860:
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2772:
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2579:
2534:
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2352:
2314:
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2011:
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43:
24:
475:. National Institutes of Health. 14 February 2014
981:Journal of Acquired Immune Deficiency Syndromes
500:Proceedings (Baylor University. Medical Center)
425:Leukoencephalopathy with vanishing white matter
349:In HIV-infected people, this may mean starting
3754:Viral infections of the central nervous system
1639:HIV-1 Associated Opportunistic Infections: PML
797:
795:
793:
791:
789:
787:
785:
783:
2824:
1812:
76:disease characterized by progressive damage (
8:
1333:: CS1 maint: multiple names: authors list (
639:; Oliver G. Pybus; Edward C. Holmes (2006).
355:immune reconstitution inflammatory syndrome
3549:
3540:
3309:
2977:
2968:
2857:
2831:
2817:
2809:
2531:
2311:
2076:Progressive multifocal leukoencephalopathy
2046:
1819:
1805:
1797:
1660:
1655:Progressive multifocal leukoencephalopathy
1337:) CS1 maint: numeric names: authors list (
545:"Seroepidemiology of Human Polyomaviruses"
66:Progressive multifocal leukoencephalopathy
54:
30:
25:Progressive multifocal leukoencephalopathy
21:
1947:Extranodal NK/T-cell lymphoma, nasal type
1575:
1518:
1469:
1420:
1219:
992:
950:
721:
664:
611:
570:
560:
519:
302:Characteristic evidence of PML on brain
451:
3620:Distal hereditary motor neuronopathies
3293:Template:Demyelinating diseases of CNS
1326:
920:
918:
916:
914:
1499:Antimicrobial Agents and Chemotherapy
463:
461:
459:
457:
455:
7:
3471:Idiopathic intracranial hypertension
351:highly active antiretroviral therapy
310:enhancing hypodense lesions without
115:, most commonly among patients with
16:Viral disease affecting human brains
2097:Subacute sclerosing panencephalitis
117:acquired immune deficiency syndrome
3702:Infantile progressive bulbar palsy
994:10.1097/01.qai.0000136093.47316.f3
600:The Journal of Infectious Diseases
14:
3405:Template:Cerebrovascular diseases
3208:Frontotemporal lobar degeneration
2416:Severe acute respiratory syndrome
1942:Follicular dendritic cell sarcoma
143:, and other autoimmune diseases.
3425:For more detailed coverage, see
3403:For more detailed coverage, see
3374:For more detailed coverage, see
3340:For more detailed coverage, see
3291:For more detailed coverage, see
2402:Middle East respiratory syndrome
1548:New England Journal of Medicine
873:US Food and Drug Administration
2001:Adult T-cell leukemia/lymphoma
1987:Splenic marginal zone lymphoma
512:10.1080/08998280.2014.11929115
295:(MRI); alternatively, a brain
212:Multiple sclerosis medications
177:The cause of PML is a type of
119:(AIDS), but people on chronic
1:
3718:Amyotrophic lateral sclerosis
3603:Hereditary spastic paraplegia
3461:Normal pressure hydrocephalus
1249:J Neurol Neurosurg Psychiatry
817:10.1016/S1474-4422(11)70149-1
3687:Progressive muscular atrophy
2206:Tropical spastic paraparesis
2111:Lymphocytic choriomeningitis
1450:Antimicrob. Agents Chemother
943:10.1212/WNL.0b013e31828c2fa1
562:10.1371/journal.ppat.1000363
72:) is a rare and often fatal
3197:Primary progressive aphasia
2569:Cytomegalovirus esophagitis
2489:Human parainfluenza viruses
2162:Ramsay Hunt syndrome type 2
1354:Clinical Drug Investigation
415:Joseph Berger (neurologist)
3785:
3519:Hashimoto's encephalopathy
3225:Posterior cortical atrophy
3046:Striatonigral degeneration
2897:Cavernous sinus thrombosis
706:10.1038/s41582-020-00427-y
306:images are multifocal, non
293:magnetic resonance imaging
236:, developed PML and died.
3625:Spinal muscular atrophies
3593:Primary lateral sclerosis
3451:Intracranial hypertension
3231:Creutzfeldt–Jakob disease
2233:Cytomegalovirus retinitis
1366:10.1007/s40261-016-0433-8
1305:10.1007/s00277-002-0481-4
1173:10.1080/13550280152537292
1083:10.1007/s00401-005-0983-y
1039:10.1007/s00401-005-0983-y
758:10.1080/13550280390195261
496:"The alien hand syndrome"
430:Toxic leukoencephalopathy
221:withdrawn from the market
100:) at multiple locations (
38:
29:
3769:Rare infectious diseases
3692:Progressive bulbar palsy
3483:Intracranial hypotension
3466:Choroid plexus papilloma
2880:Herpesviral encephalitis
2335:Infectious mononucleosis
2152:Chandipura vesiculovirus
1982:Hepatocellular carcinoma
1927:Nasopharyngeal carcinoma
1860:Hepatocellular carcinoma
1650:MedlinePlus Encyclopedia
1261:10.1136/jnnp.2009.190652
694:Nature Reviews Neurology
372:In June 2010, the first
3204:Frontotemporal dementia
2890:Encephalitis lethargica
2131:Encephalitis lethargica
1832:viral systemic diseases
335:posterior cranial fossa
104:). It is caused by the
3509:Hepatic encephalopathy
2503:Human orthopneumovirus
2157:Herpesviral meningitis
2118:Arbovirus encephalitis
752:9 Suppl 1 (2): 38–41.
195:antiretroviral therapy
123:medications including
3567:Ataxia–telangiectasia
3524:Static encephalopathy
3247:Mitochondrial disease
3085:Spasmodic torticollis
2995:Basal ganglia disease
1961:Merkel-cell carcinoma
1560:10.1056/nejmoa1801540
1027:Acta Neuropathologica
635:Laura A. Shackelton;
257:demyelinating disease
3514:Toxic encephalopathy
3220:Lewy bodies dementia
2606:Adenovirus infection
2070:Human polyomavirus 2
1899:Oropharyngeal cancer
1511:10.1128/AAC.00046-11
1462:10.1128/AAC.00046-11
1413:10.1128/CMR.05031-11
1401:Clin. Microbiol. Rev
1221:10.1056/NEJMoa051847
657:10.1128/JVI.00441-06
440:It's My Party (film)
263:sheath covering the
141:rheumatoid arthritis
3764:Slow virus diseases
3562:Friedreich's ataxia
2945:Meningoencephalitis
2885:Limbic encephalitis
2192:Post-polio syndrome
1828:Infectious diseases
645:Journal of Virology
420:Leukoencephalopathy
162:alien hand syndrome
3598:Pseudobulbar palsy
3336:Status epilepticus
3287:Multiple sclerosis
3124:Myoclonic epilepsy
2987:movement disorders
2933:Acute disseminated
2875:Viral encephalitis
2325:Epstein–Barr virus
2295:Respiratory system
1932:Burkitt's lymphoma
1749:External resources
225:interferon beta-1a
173:JC virus infection
147:Signs and symptoms
133:multiple sclerosis
129:Hodgkin's lymphoma
3736:
3735:
3732:
3731:
3728:
3727:
3532:
3531:
3437:
3436:
3376:Template:Headache
3342:Template:Epilepsy
3263:
3262:
3237:Vascular dementia
3080:Status dystonicus
2953:
2952:
2928:Encephalomyelitis
2806:
2805:
2768:
2767:
2519:
2518:
2450:Influenza virus A
2367:Human coronavirus
2257:
2256:
2247:Herpes of the eye
1794:
1793:
1554:(15): 1443–1451.
1130:10.1345/aph.10338
651:(20): 9928–9933.
234:dimethyl fumarate
189:Immunosuppression
121:immunosuppressive
113:immune deficiency
63:
62:
19:Medical condition
3776:
3550:
3541:
3499:Brain herniation
3310:
3150:Intention tremor
3145:Essential tremor
3010:Postencephalitic
2978:
2969:
2858:
2839:Diseases of the
2833:
2826:
2819:
2810:
2532:
2527:digestive system
2444:Orthomyxoviridae
2410:SARS coronavirus
2396:MERS coronavirus
2312:
2124:Orthomyxoviridae
2047:
2013:Immune disorders
1937:Hodgkin lymphoma
1913:Kaposi's sarcoma
1821:
1814:
1807:
1798:
1661:
1616:
1615:
1613:
1611:
1596:
1590:
1589:
1579:
1539:
1533:
1532:
1522:
1505:(5): 2129–2136.
1490:
1484:
1483:
1473:
1441:
1435:
1434:
1424:
1392:
1386:
1385:
1349:
1343:
1342:
1332:
1324:
1287:
1281:
1280:
1240:
1234:
1233:
1223:
1199:
1193:
1192:
1156:
1150:
1149:
1118:Ann Pharmacother
1109:
1103:
1102:
1071:Acta Neuropathol
1065:
1059:
1058:
1021:
1015:
1014:
996:
987:(2): 1263–1268.
971:
965:
964:
954:
922:
909:
908:
906:
905:
890:
884:
883:
881:
879:
865:
859:
858:
851:
845:
844:
805:Lancet Neurology
799:
778:
777:
742:
736:
735:
725:
685:
679:
678:
668:
632:
626:
625:
615:
591:
585:
584:
574:
564:
540:
534:
533:
523:
491:
485:
484:
482:
480:
465:
331:external capsule
269:oligodendrocytes
244:approved in 2010
59:
58:
34:
22:
3784:
3783:
3779:
3778:
3777:
3775:
3774:
3773:
3749:Brain disorders
3739:
3738:
3737:
3724:
3650:Congenital DSMA
3571:
3528:
3487:
3433:
3421:Sleep disorders
3409:
3386:Cerebrovascular
3380:
3346:
3303:
3297:
3259:
3241:
3166:
3112:Choreoathetosis
2985:
2962:
2949:
2913:
2847:
2837:
2807:
2802:
2764:
2744:
2652:
2626:Gastroenteritis
2584:
2581:Gastroenteritis
2575:
2563:Cytomegalovirus
2526:
2515:
2483:Paramyxoviridae
2472:Avian influenza
2348:
2343:Cytomegalovirus
2307:viral pneumonia
2305:
2302:nasopharyngitis
2301:
2298:
2289:
2253:
2227:Cytomegalovirus
2212:
2166:
2054:
2041:
2034:
2007:
1874:Cervical cancer
1834:
1825:
1795:
1790:
1789:
1744:
1743:
1672:
1625:
1620:
1619:
1609:
1607:
1606:. December 2021
1598:
1597:
1593:
1541:
1540:
1536:
1492:
1491:
1487:
1443:
1442:
1438:
1394:
1393:
1389:
1351:
1350:
1346:
1325:
1289:
1288:
1284:
1242:
1241:
1237:
1208:N. Engl. J. Med
1201:
1200:
1196:
1158:
1157:
1153:
1111:
1110:
1106:
1067:
1066:
1062:
1023:
1022:
1018:
973:
972:
968:
924:
923:
912:
903:
901:
892:
891:
887:
877:
875:
867:
866:
862:
853:
852:
848:
801:
800:
781:
744:
743:
739:
687:
686:
682:
634:
633:
629:
593:
592:
588:
555:(3): e1000363.
542:
541:
537:
493:
492:
488:
478:
476:
467:
466:
453:
448:
411:
402:
343:
323:occipital lobes
281:
259:, in which the
253:
214:
191:
175:
170:
149:
53:
20:
17:
12:
11:
5:
3782:
3780:
3772:
3771:
3766:
3761:
3756:
3751:
3741:
3740:
3734:
3733:
3730:
3729:
3726:
3725:
3723:
3722:
3721:
3720:
3709:
3708:
3707:
3706:
3705:
3704:
3699:
3689:
3684:
3683:
3682:
3677:
3672:
3671:
3670:
3665:
3660:
3652:
3647:
3642:
3637:
3632:
3622:
3608:
3607:
3606:
3605:
3600:
3595:
3581:
3579:
3573:
3572:
3570:
3569:
3564:
3558:
3556:
3547:
3538:
3534:
3533:
3530:
3529:
3527:
3526:
3521:
3516:
3511:
3506:
3501:
3495:
3493:
3489:
3488:
3486:
3485:
3480:
3478:Cerebral edema
3475:
3474:
3473:
3468:
3463:
3458:
3447:
3445:
3439:
3438:
3435:
3434:
3432:
3431:
3430:
3429:
3427:Template:Sleep
3417:
3415:
3411:
3410:
3408:
3407:
3401:
3396:
3390:
3388:
3382:
3381:
3379:
3378:
3372:
3367:
3362:
3356:
3354:
3348:
3347:
3345:
3344:
3338:
3333:
3328:
3322:
3320:
3307:
3299:
3298:
3296:
3295:
3289:
3284:
3279:
3273:
3271:
3265:
3264:
3261:
3260:
3258:
3257:
3255:Leigh syndrome
3251:
3249:
3243:
3242:
3240:
3239:
3228:
3227:
3222:
3217:
3216:
3215:
3201:
3200:
3199:
3194:
3193:
3192:
3176:
3174:
3168:
3167:
3165:
3164:
3159:
3154:
3153:
3152:
3147:
3136:
3135:
3134:
3133:
3128:
3127:
3126:
3116:
3115:
3114:
3104:
3099:
3098:
3097:
3092:
3087:
3082:
3066:
3065:
3064:
3063:
3058:
3053:
3048:
3043:
3042:
3041:
3031:
3030:
3029:
3019:
3018:
3017:
3012:
3007:
2991:
2989:
2982:Extrapyramidal
2975:
2966:
2964:encephalopathy
2955:
2954:
2951:
2950:
2948:
2947:
2942:
2937:
2936:
2935:
2924:
2922:
2915:
2914:
2912:
2911:
2910:
2909:
2899:
2894:
2893:
2892:
2887:
2882:
2877:
2866:
2864:
2855:
2849:
2848:
2841:nervous system
2838:
2836:
2835:
2828:
2821:
2813:
2804:
2803:
2801:
2800:
2799:
2798:
2786:
2778:
2776:
2770:
2769:
2766:
2765:
2763:
2762:
2754:
2752:
2746:
2745:
2743:
2742:
2730:
2718:
2706:
2694:
2687:
2681:
2680:
2668:
2662:
2660:
2654:
2653:
2651:
2650:
2643:
2636:
2629:
2617:
2611:
2610:
2609:
2608:
2596:
2590:
2588:
2577:
2576:
2574:
2573:
2572:
2571:
2559:
2558:
2557:
2544:
2542:
2529:
2521:
2520:
2517:
2516:
2514:
2513:
2506:
2499:
2498:
2497:
2477:
2476:
2475:
2474:
2435:
2434:
2433:
2432:
2420:
2419:
2418:
2406:
2405:
2404:
2392:
2391:
2390:
2358:
2356:
2350:
2349:
2347:
2346:
2339:
2338:
2337:
2320:
2318:
2309:
2291:
2290:
2288:
2287:
2286:
2285:
2280:
2267:
2265:
2263:Cardiovascular
2259:
2258:
2255:
2254:
2252:
2251:
2250:
2249:
2237:
2236:
2235:
2222:
2220:
2214:
2213:
2211:
2210:
2209:
2208:
2196:
2195:
2194:
2189:
2176:
2174:
2168:
2167:
2165:
2164:
2159:
2154:
2149:
2148:
2147:
2135:
2134:
2133:
2120:
2115:
2114:
2113:
2101:
2100:
2099:
2087:
2081:
2080:
2079:
2078:
2066:
2060:
2058:
2044:
2042:nervous system
2036:
2035:
2033:
2032:
2031:
2030:
2017:
2015:
2009:
2008:
2006:
2005:
2004:
2003:
1991:
1990:
1989:
1984:
1972:
1966:
1965:
1964:
1963:
1951:
1950:
1949:
1944:
1939:
1934:
1929:
1917:
1916:
1915:
1903:
1902:
1901:
1896:
1894:Vaginal cancer
1891:
1886:
1881:
1876:
1864:
1863:
1862:
1850:
1844:
1842:
1836:
1835:
1826:
1824:
1823:
1816:
1809:
1801:
1792:
1791:
1788:
1787:
1776:
1765:
1753:
1752:
1750:
1746:
1745:
1742:
1741:
1730:
1719:
1704:
1689:
1673:
1668:
1667:
1665:
1664:Classification
1658:
1657:
1646:
1635:
1624:
1623:External links
1621:
1618:
1617:
1591:
1534:
1485:
1456:(5): 2129–36.
1436:
1407:(3): 471–506.
1387:
1344:
1282:
1255:(4): 452–455.
1235:
1194:
1151:
1104:
1060:
1033:(4): 449–455.
1016:
966:
937:(15): 1430–8.
910:
885:
860:
846:
779:
749:J. Neurovirol.
737:
680:
637:Andrew Rambaut
627:
613:10.1086/597126
586:
549:PLOS Pathogens
535:
506:(3): 219–220.
486:
450:
449:
447:
444:
443:
442:
437:
432:
427:
422:
417:
410:
407:
401:
398:
342:
339:
280:
277:
252:
249:
242:(Gilenya) was
213:
210:
190:
187:
174:
171:
169:
166:
148:
145:
61:
60:
47:
41:
40:
36:
35:
27:
26:
18:
15:
13:
10:
9:
6:
4:
3:
2:
3781:
3770:
3767:
3765:
3762:
3760:
3759:Rare diseases
3757:
3755:
3752:
3750:
3747:
3746:
3744:
3719:
3716:
3715:
3714:
3711:
3710:
3703:
3700:
3698:
3695:
3694:
3693:
3690:
3688:
3685:
3681:
3678:
3676:
3673:
3669:
3666:
3664:
3661:
3659:
3656:
3655:
3653:
3651:
3648:
3646:
3643:
3641:
3638:
3636:
3633:
3631:
3628:
3627:
3626:
3623:
3621:
3618:
3617:
3616:
3614:
3610:
3609:
3604:
3601:
3599:
3596:
3594:
3591:
3590:
3589:
3587:
3583:
3582:
3580:
3578:
3574:
3568:
3565:
3563:
3560:
3559:
3557:
3555:
3551:
3548:
3546:
3542:
3539:
3535:
3525:
3522:
3520:
3517:
3515:
3512:
3510:
3507:
3505:
3504:Reye syndrome
3502:
3500:
3497:
3496:
3494:
3490:
3484:
3481:
3479:
3476:
3472:
3469:
3467:
3464:
3462:
3459:
3457:
3456:Hydrocephalus
3454:
3453:
3452:
3449:
3448:
3446:
3444:
3440:
3428:
3424:
3423:
3422:
3419:
3418:
3416:
3412:
3406:
3402:
3400:
3397:
3395:
3392:
3391:
3389:
3387:
3383:
3377:
3373:
3371:
3368:
3366:
3363:
3361:
3358:
3357:
3355:
3353:
3349:
3343:
3339:
3337:
3334:
3332:
3329:
3327:
3324:
3323:
3321:
3319:
3315:
3311:
3308:
3306:
3300:
3294:
3290:
3288:
3285:
3283:
3280:
3278:
3275:
3274:
3272:
3270:
3269:Demyelinating
3266:
3256:
3253:
3252:
3250:
3248:
3244:
3238:
3235:
3234:
3233:
3232:
3226:
3223:
3221:
3218:
3214:
3211:
3210:
3209:
3205:
3202:
3198:
3195:
3191:
3188:
3187:
3186:
3183:
3182:
3181:
3178:
3177:
3175:
3173:
3169:
3163:
3160:
3158:
3157:Restless legs
3155:
3151:
3148:
3146:
3143:
3142:
3141:
3138:
3137:
3132:
3129:
3125:
3122:
3121:
3120:
3117:
3113:
3110:
3109:
3108:
3105:
3103:
3100:
3096:
3095:Blepharospasm
3093:
3091:
3088:
3086:
3083:
3081:
3078:
3077:
3076:
3073:
3072:
3071:
3068:
3067:
3062:
3059:
3057:
3054:
3052:
3051:Hemiballismus
3049:
3047:
3044:
3040:
3037:
3036:
3035:
3032:
3028:
3025:
3024:
3023:
3020:
3016:
3013:
3011:
3008:
3006:
3003:
3002:
3001:
2998:
2997:
2996:
2993:
2992:
2990:
2988:
2983:
2979:
2976:
2974:
2970:
2967:
2965:
2960:
2956:
2946:
2943:
2941:
2938:
2934:
2931:
2930:
2929:
2926:
2925:
2923:
2921:
2916:
2908:
2905:
2904:
2903:
2902:Brain abscess
2900:
2898:
2895:
2891:
2888:
2886:
2883:
2881:
2878:
2876:
2873:
2872:
2871:
2868:
2867:
2865:
2863:
2859:
2856:
2854:
2850:
2846:
2842:
2834:
2829:
2827:
2822:
2820:
2815:
2814:
2811:
2797:
2794:
2793:
2792:
2791:
2787:
2785:
2784:
2780:
2779:
2777:
2775:
2771:
2761:
2760:
2756:
2755:
2753:
2751:
2747:
2740:
2736:
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2724:
2723:
2719:
2716:
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2663:
2661:
2659:
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2649:
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2644:
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2641:
2637:
2635:
2634:
2630:
2627:
2623:
2622:
2618:
2616:
2613:
2612:
2607:
2604:
2603:
2602:
2601:
2597:
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2592:
2591:
2589:
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2570:
2567:
2566:
2565:
2564:
2560:
2556:
2553:
2552:
2551:
2550:
2546:
2545:
2543:
2541:
2537:
2533:
2530:
2528:
2522:
2512:
2511:
2507:
2505:
2504:
2500:
2496:
2495:Parainfluenza
2493:
2492:
2491:
2490:
2485:
2484:
2479:
2478:
2473:
2469:
2466:
2465:
2464:
2463:
2459:
2455:
2451:
2446:
2445:
2440:
2437:
2436:
2431:
2428:
2427:
2426:
2425:
2421:
2417:
2414:
2413:
2412:
2411:
2407:
2403:
2400:
2399:
2398:
2397:
2393:
2389:
2386:
2385:
2384:
2383:
2379:
2375:
2371:
2368:
2363:
2360:
2359:
2357:
2355:
2351:
2345:
2344:
2340:
2336:
2332:
2331:EBV infection
2329:
2328:
2327:
2326:
2322:
2321:
2319:
2317:
2313:
2310:
2308:
2303:
2296:
2292:
2284:
2281:
2279:
2276:
2275:
2274:
2273:
2269:
2268:
2266:
2264:
2260:
2248:
2245:
2244:
2243:
2242:
2238:
2234:
2231:
2230:
2229:
2228:
2224:
2223:
2221:
2219:
2215:
2207:
2204:
2203:
2202:
2201:
2197:
2193:
2190:
2188:
2187:Poliomyelitis
2185:
2184:
2183:
2182:
2178:
2177:
2175:
2173:
2169:
2163:
2160:
2158:
2155:
2153:
2150:
2146:
2143:
2142:
2141:
2140:
2136:
2132:
2129:
2128:
2126:
2125:
2121:
2119:
2116:
2112:
2109:
2108:
2107:
2106:
2102:
2098:
2095:
2094:
2093:
2092:
2088:
2086:
2083:
2082:
2077:
2074:
2073:
2072:
2071:
2067:
2065:
2062:
2061:
2059:
2057:
2052:
2048:
2045:
2043:
2037:
2029:
2026:
2025:
2024:
2023:
2019:
2018:
2016:
2014:
2010:
2002:
1999:
1998:
1997:
1996:
1992:
1988:
1985:
1983:
1980:
1979:
1978:
1977:
1973:
1971:
1968:
1967:
1962:
1959:
1958:
1957:
1956:
1952:
1948:
1945:
1943:
1940:
1938:
1935:
1933:
1930:
1928:
1925:
1924:
1923:
1922:
1918:
1914:
1911:
1910:
1909:
1908:
1904:
1900:
1897:
1895:
1892:
1890:
1889:Vulvar cancer
1887:
1885:
1884:Penile cancer
1882:
1880:
1877:
1875:
1872:
1871:
1870:
1869:
1865:
1861:
1858:
1857:
1856:
1855:
1851:
1849:
1846:
1845:
1843:
1841:
1837:
1833:
1829:
1822:
1817:
1815:
1810:
1808:
1803:
1802:
1799:
1786:
1782:
1781:
1777:
1775:
1771:
1770:
1766:
1764:
1760:
1759:
1755:
1754:
1751:
1747:
1740:
1736:
1735:
1731:
1729:
1725:
1724:
1720:
1718:
1714:
1713:
1709:
1705:
1703:
1699:
1698:
1694:
1690:
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1684:
1683:
1679:
1675:
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1636:
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1627:
1626:
1622:
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1604:BUSINESS WIRE
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1561:
1557:
1553:
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1538:
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1516:
1512:
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1496:
1489:
1486:
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1477:
1472:
1467:
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1410:
1406:
1402:
1398:
1391:
1388:
1383:
1379:
1375:
1371:
1367:
1363:
1360:(10): 783–9.
1359:
1355:
1348:
1345:
1340:
1336:
1330:
1322:
1318:
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1306:
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1262:
1258:
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1236:
1231:
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1209:
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1195:
1190:
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1174:
1170:
1167:(4): 386–90.
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1162:
1161:J. Neurovirol
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1152:
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1143:
1139:
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1131:
1127:
1123:
1119:
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1108:
1105:
1100:
1096:
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1088:
1084:
1080:
1077:(4): 449–55.
1076:
1072:
1064:
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1017:
1012:
1008:
1004:
1000:
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986:
982:
978:
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967:
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919:
917:
915:
911:
900:
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889:
886:
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870:
864:
861:
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850:
847:
842:
838:
834:
830:
826:
825:2078.1/124907
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814:
811:(8): 745–58.
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790:
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784:
780:
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767:
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750:
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729:
724:
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646:
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623:
619:
614:
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606:(6): 837–46.
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431:
428:
426:
423:
421:
418:
416:
413:
412:
408:
406:
399:
397:
395:
394:Brincidofovir
391:
387:
383:
382:interleukin-2
379:
375:
370:
368:
364:
362:
358:
356:
352:
347:
340:
338:
336:
332:
328:
327:basal ganglia
324:
321:
317:
313:
309:
305:
300:
298:
294:
290:
286:
278:
276:
274:
271:and produces
270:
266:
262:
258:
250:
248:
245:
241:
237:
235:
230:
226:
222:
218:
211:
209:
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203:
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188:
186:
184:
180:
172:
167:
165:
163:
159:
155:
146:
144:
142:
138:
134:
130:
126:
122:
118:
114:
109:
107:
103:
99:
95:
91:
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51:
48:
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42:
37:
33:
28:
23:
3712:
3611:
3584:
3545:Degenerative
3282:Inflammatory
3229:
3162:Stiff-person
3000:Parkinsonism
2973:Degenerative
2870:Encephalitis
2853:Inflammation
2843:, primarily
2788:
2781:
2757:
2750:Pancreatitis
2732:
2720:
2708:
2696:
2689:
2670:
2645:
2638:
2631:
2619:
2598:
2561:
2547:
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2501:
2487:
2481:
2448:
2442:
2422:
2408:
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2365:
2341:
2323:
2278:Pericarditis
2270:
2239:
2225:
2198:
2179:
2137:
2122:
2103:
2089:
2075:
2068:
2051:Encephalitis
2020:
1993:
1974:
1953:
1919:
1905:
1866:
1852:
1778:
1767:
1756:
1732:
1721:
1706:
1691:
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1648:
1637:
1608:. Retrieved
1603:
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1488:
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1400:
1390:
1357:
1353:
1347:
1329:cite journal
1299:(7): 410–3.
1296:
1292:
1285:
1252:
1248:
1238:
1211:
1207:
1197:
1164:
1160:
1154:
1124:(6): 741–4.
1121:
1117:
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1070:
1063:
1030:
1026:
1019:
984:
980:
969:
934:
930:
902:. Retrieved
898:
888:
876:. Retrieved
872:
863:
849:
808:
804:
747:
740:
700:(1): 37–51.
697:
693:
683:
648:
644:
630:
603:
599:
589:
552:
548:
538:
503:
499:
489:
479:11 September
477:. Retrieved
472:
435:Pedro Zamora
403:
390:cell culture
371:
365:
359:
348:
344:
301:
289:spinal fluid
282:
273:intranuclear
254:
251:Pathogenesis
238:
215:
199:
192:
179:polyomavirus
176:
150:
125:chemotherapy
110:
101:
97:
89:
86:white matter
82:inflammation
77:
69:
65:
64:
3697:Fazio–Londe
3537:Both/either
3331:Generalised
3190:Early-onset
3185:Alzheimer's
2920:spinal cord
2647:Coronavirus
2388:Common cold
2300:acute viral
2283:Myocarditis
2127:(probable)
1879:Anal cancer
1758:MedlinePlus
1293:Ann Hematol
899:Radiopaedia
878:31 December
386:mirtazapine
374:case report
312:mass effect
217:Natalizumab
181:called the
98:-encephalo-
3743:Categories
3305:paroxysmal
3277:Autoimmune
3070:Dyskinesia
2940:Meningitis
2918:Brain and
2774:Urogenital
2640:Astrovirus
2600:Adenovirus
2424:SARS-CoV-2
2181:Poliovirus
2056:meningitis
1734:DiseasesDB
904:2019-03-09
893:Radswiki.
446:References
378:mefloquine
367:Cytarabine
240:Fingolimod
229:prevalence
206:belatacept
202:efalizumab
102:multifocal
3302:Episodic/
3180:Tauopathy
3131:Akathisia
3119:Myoclonus
3102:Athetosis
3034:Tauopathy
2685:RNA virus
2666:DNA virus
2658:Hepatitis
2633:Norovirus
2621:Rotavirus
2615:RNA virus
2594:DNA virus
2540:Esophagus
2468:Influenza
2354:RNA virus
2316:DNA virus
2085:RNA virus
2064:DNA virus
1970:RNA virus
1848:DNA virus
1840:Oncovirus
1774:radio/573
1769:eMedicine
1644:eMedicine
1568:0028-4793
931:Neurology
714:1759-4766
400:Prognosis
361:Cidofovir
341:Treatment
279:Diagnosis
255:PML is a
247:label").
158:occipital
137:psoriasis
92:) of the
50:Neurology
45:Specialty
3668:SMALED2B
3663:SMALED2A
3360:Migraine
3352:Headache
3318:epilepsy
3314:Seizures
3172:Dementia
3075:Dystonia
2783:BK virus
2586:diarrhea
2430:COVID-19
2172:Myelitis
1780:Orphanet
1629:Overview
1586:30304652
1529:21402853
1480:21402853
1431:22763635
1382:34008609
1374:27401779
1321:24949477
1313:12185517
1277:19877728
1269:20562463
1230:15947078
1189:12159275
1181:11517422
1146:32026770
1138:11408993
1099:23865244
1091:15739098
1055:23865244
1047:15739098
1011:23613081
1003:15385733
961:23568998
841:15639613
833:21777829
774:17171153
766:12709870
732:33219338
675:17005670
622:19434930
581:19325891
530:24982566
409:See also
308:contrast
183:JC virus
154:parietal
106:JC virus
3680:SMA-PME
3675:SMA-PCH
3658:SMALED1
3370:Tension
3365:Cluster
3090:Meige's
2907:Amoebic
2536:Pharynx
2040:Central
1728:D007968
1687:8A45.02
1577:6283403
1520:3088264
1471:3088264
1422:3416490
952:3662270
723:7678594
666:1617318
572:2655709
521:4059570
320:parieto
316:frontal
304:CT scan
84:of the
3399:Stroke
3213:Pick's
3140:Tremor
3107:Chorea
2200:HTLV-I
2145:Rabies
1995:HTLV-I
1785:217260
1763:000674
1584:
1574:
1566:
1527:
1517:
1478:
1468:
1429:
1419:
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1372:
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720:
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673:
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569:
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518:
333:, and
297:biopsy
261:myelin
90:leuko-
78:-pathy
52:
3713:both:
3645:DSMA1
3640:SMAX2
3635:SMAX1
3615:only:
3588:only:
3492:Other
3414:Other
3326:Focal
2959:Brain
2862:Brain
2796:Mumps
2555:Mumps
2525:Human
1955:MCPyV
1739:10718
1717:046.3
1702:A81.2
1610:3 May
1378:S2CID
1317:S2CID
1273:S2CID
1185:S2CID
1142:S2CID
1095:S2CID
1051:S2CID
1007:S2CID
837:S2CID
770:S2CID
265:axons
168:Cause
94:brain
80:) or
74:viral
3316:and
3027:PKAN
3022:NBIA
2510:hMPV
2382:OC43
2378:HKU1
2374:NL63
2370:229E
2028:AIDS
1907:KSHV
1723:MeSH
1712:9-CM
1612:2022
1582:PMID
1564:ISSN
1525:PMID
1476:PMID
1427:PMID
1370:PMID
1339:link
1335:link
1309:PMID
1265:PMID
1226:PMID
1177:PMID
1134:PMID
1087:PMID
1043:PMID
999:PMID
957:PMID
880:2018
829:PMID
762:PMID
728:PMID
710:ISSN
671:PMID
618:PMID
577:PMID
526:PMID
481:2020
318:and
156:and
3630:SMA
3613:LMN
3586:UMN
3577:MND
3443:CSF
3394:TIA
3039:PSP
3015:NMS
2984:and
2845:CNS
2790:MuV
2759:CBV
2734:HEV
2722:HDV
2710:HCV
2698:HAV
2691:CBV
2672:HBV
2549:MuV
2480:V,
2272:CBV
2241:HSV
2218:Eye
2105:LCV
2091:MeV
2022:HIV
1976:HCV
1921:EBV
1868:HPV
1854:HBV
1708:ICD
1693:ICD
1678:ICD
1642:at
1633:NIH
1631:at
1572:PMC
1556:doi
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1362:doi
1301:doi
1257:doi
1216:doi
1212:353
1169:doi
1126:doi
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989:doi
947:PMC
939:doi
821:hdl
813:doi
754:doi
718:PMC
702:doi
661:PMC
653:doi
608:doi
604:199
567:PMC
557:doi
516:PMC
508:doi
287:in
285:DNA
70:PML
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3061:OA
3056:HD
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