Quantitative electroencephalography supports diagnosis of natalizumab-associated progressive multifocal leukoencephalopathy

J Neurovirol. 2019 Feb;25(1):133-136. doi: 10.1007/s13365-018-0689-2. Epub 2018 Nov 9.

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Electroencephalography / methods*
  • Female
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects*
  • JC Virus / drug effects*
  • JC Virus / growth & development
  • JC Virus / pathogenicity
  • Leukoencephalopathy, Progressive Multifocal / chemically induced
  • Leukoencephalopathy, Progressive Multifocal / diagnosis*
  • Leukoencephalopathy, Progressive Multifocal / pathology
  • Leukoencephalopathy, Progressive Multifocal / virology
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Multiple Sclerosis, Relapsing-Remitting / pathology
  • Natalizumab / administration & dosage
  • Natalizumab / adverse effects*
  • Prognosis
  • Retrospective Studies
  • Virus Activation / drug effects

Substances

  • Immunologic Factors
  • Natalizumab