Abstract
Long-term treatment of multiple sclerosis with natalizumab (NTZ) carries the risk of a devastating complication in the form of an encephalopathy caused by a reactivation of a latent John Cunningham virus infection (progressive multifocal leucoencephalopathy, PML). Early diagnosis is associated with considerably better prognosis. Quantitative EEG as an objective, rater-independent technique provides high sensitivity (88%) and specificity (82%) for the diagnosis of NTZ-PML. Combination of diagnostic modalities addressing static morphological (brain MRI) as well as functional (EEG) pathologic changes may improve risk management programmes.
Keywords:
EEG; John Cunningham virus encephalopathy; Multiple sclerosis; Natalizumab; Pharmacovigilance; Screening.
MeSH terms
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Adult
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Electroencephalography / methods*
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Female
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Humans
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Immunologic Factors / administration & dosage
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Immunologic Factors / adverse effects*
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JC Virus / drug effects*
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JC Virus / growth & development
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JC Virus / pathogenicity
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Leukoencephalopathy, Progressive Multifocal / chemically induced
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Leukoencephalopathy, Progressive Multifocal / diagnosis*
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Leukoencephalopathy, Progressive Multifocal / pathology
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Leukoencephalopathy, Progressive Multifocal / virology
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Male
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Middle Aged
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Multiple Sclerosis, Relapsing-Remitting / diagnosis
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Multiple Sclerosis, Relapsing-Remitting / drug therapy*
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Multiple Sclerosis, Relapsing-Remitting / pathology
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Natalizumab / administration & dosage
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Natalizumab / adverse effects*
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Prognosis
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Retrospective Studies
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Virus Activation / drug effects
Substances
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Immunologic Factors
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Natalizumab