Akinetic Mutism Caused by HIV-associated Progressive Multifocal Leukoencephalopathy was Successfully Treated with Mefloquine: A Serial Multimodal MRI Study

作者：Naito Kasane; Ueno Hiroki^*; Sekine Mayu; Kanemitsu Munekazu; Ohshita Tomohiko; Nakamura Takeshi; Yamawaki Takemori; Matsumoto Masayasu

来源：Internal Medicine, 2012, 51(2): 205-209.

DOI：10.2169/internalmedicine.51.6253

• progressive multifocal leukoencephalopathy (PML)
• human immunodeficiency virus infection (HIV)
• highly active anti-retroviral therapy (HAART)
• mefloquine
• proton magnetic resonance spectroscopy ((1)H-MRS)
• apparent diffusion coefficient (ADC)

We report a case of a patient with highly active anti-retroviral therapy-resistant human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML). The patient showed an improvement in imaging findings and clinical symptoms after mefloquine was introduced as an additional treatment. Serial assessment of white matter lesions was conducted by proton magnetic resonance spectroscopy ((1)H-MRS) and diffusion-weighted imaging (DWI). As the clinical symptoms improved, the N-acetylaspartate/creatine ratio increased, the choline/creatine ratio decreased, and the elevated ADC value decreased. These concomitant changes suggested that (1)H-MRS and DWI were useful for the assessment of the therapeutic effect on PML.

• 出版日期2012