BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuProgressive multifocal leukoencephalopathyPML; John Cunningham virus; JCV; Human polyomavirus 2; JC virusProgressive multifocal leukoencephalopathy (PML) is a rare infection that damages the material (myelin) that covers and protects nerves in the white matter of the brain.MyelinMyelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...ImageRead Article Now Book Mark Article White matter of the brainWhite matter is found in the deeper tissues of the brain (subcortical). It contains nerve fibers (axons), which are extensions of nerve cells (neuro...ImageRead Article Now Book Mark Article Causes The John Cunningham virus, or JC virus (JCV), causes PML. JCV is also known as human polyomavirus 2. By age 10, most people have been infected with JCV, but it rarely causes symptoms. The virus remains in the body, but normally is inactive and causes no problems. But people with a weakened immune system are at risk of developing PML. Causes of a weakened immune system include:HIV/AIDS (less common now because of better management of HIV/AIDS). HIV/AIDSHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Medicines that suppress the immune system, including monoclonal antibodies. These medicines are used to prevent organ transplant rejection or to treat multiple sclerosis, rheumatoid arthritis and other autoimmune disorders, and related conditions. Cancers, such as leukemia and Hodgkin lymphoma. Symptoms Symptoms may include any of the following: Loss of coordination, clumsiness Loss of language ability (aphasia) AphasiaSpeech and language impairment may be any of several problems that make it difficult to communicate.Read Article Now Book Mark Article Memory loss Vision problems Weakness of the legs and arms that gets worse Personality changes Exams and Tests Your health care provider will perform a physical exam and ask about symptoms.Tests may include:Brain biopsy (in rare cases) Cerebrospinal fluid analysis and blood test for the JCV Cerebrospinal fluid analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article CT scan of the brain CT scan of the brainA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.ImageRead Article Now Book Mark Article MRI of the brainMRI of the brainA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Treatment In people with HIV/AIDS, treatment to strengthen the immune system can lead to recovery from the symptoms of PML. No other treatments have proved effective for PML. Medicines to treat PML are being developed and may be available in the near future. Outlook (Prognosis) PML is a life-threatening condition. Depending on how severe the infection is, up to one half of people diagnosed with PML die within the first few months. Talk to your provider about care decisions.Open ReferencesReferencesHirsch HH. Polyomaviruses. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 341.Tan CS, Koralnik IJ. JC, BK, and other polyomaviruses: progressive multifocal leukoencephalopathy (PML). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 144.AllVideoImagesTogGray and white matter of the brain - illustration The tissue called gray matter in the brain and spinal cord is also known as substantia grisea, and is made up of cell bodies. White matter, or substantia alba, is composed of nerve fibers.Gray and white matter of the brainillustrationLeukoencephalopathy - illustration Progressive multifocal leukoencephalopathy is an advancing viral inflammation of the white matter of the brain. Immunosuppressed people are more susceptible to this disorder than the general population. Evidence of the disease may be a person's recent loss of coordination and weakness, progressing to a loss of language, visual problems and headaches.LeukoencephalopathyillustrationGray and white matter of the brain - illustration The tissue called gray matter in the brain and spinal cord is also known as substantia grisea, and is made up of cell bodies. White matter, or substantia alba, is composed of nerve fibers.Gray and white matter of the brainillustrationLeukoencephalopathy - illustration Progressive multifocal leukoencephalopathy is an advancing viral inflammation of the white matter of the brain. Immunosuppressed people are more susceptible to this disorder than the general population. Evidence of the disease may be a person's recent loss of coordination and weakness, progressing to a loss of language, visual problems and headaches.LeukoencephalopathyillustrationRelated Information White matter of the brain(Special Topic)Movement - uncoordinated(Symptoms)Weakness(Symptoms)Visual field(Medical Test)Headache(Symptoms)Immunodeficiency disorders(Condition) Review Date: 3/31/2024 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. 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Progressive multifocal leukoencephalopathyPML; John Cunningham virus; JCV; Human polyomavirus 2; JC virusProgressive multifocal leukoencephalopathy (PML) is a rare infection that damages the material (myelin) that covers and protects nerves in the white matter of the brain.MyelinMyelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...ImageRead Article Now Book Mark Article White matter of the brainWhite matter is found in the deeper tissues of the brain (subcortical). It contains nerve fibers (axons), which are extensions of nerve cells (neuro...ImageRead Article Now Book Mark Article Causes The John Cunningham virus, or JC virus (JCV), causes PML. JCV is also known as human polyomavirus 2. By age 10, most people have been infected with JCV, but it rarely causes symptoms. The virus remains in the body, but normally is inactive and causes no problems. But people with a weakened immune system are at risk of developing PML. Causes of a weakened immune system include:HIV/AIDS (less common now because of better management of HIV/AIDS). HIV/AIDSHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Medicines that suppress the immune system, including monoclonal antibodies. These medicines are used to prevent organ transplant rejection or to treat multiple sclerosis, rheumatoid arthritis and other autoimmune disorders, and related conditions. Cancers, such as leukemia and Hodgkin lymphoma. Symptoms Symptoms may include any of the following: Loss of coordination, clumsiness Loss of language ability (aphasia) AphasiaSpeech and language impairment may be any of several problems that make it difficult to communicate.Read Article Now Book Mark Article Memory loss Vision problems Weakness of the legs and arms that gets worse Personality changes Exams and Tests Your health care provider will perform a physical exam and ask about symptoms.Tests may include:Brain biopsy (in rare cases) Cerebrospinal fluid analysis and blood test for the JCV Cerebrospinal fluid analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article CT scan of the brain CT scan of the brainA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.ImageRead Article Now Book Mark Article MRI of the brainMRI of the brainA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Treatment In people with HIV/AIDS, treatment to strengthen the immune system can lead to recovery from the symptoms of PML. No other treatments have proved effective for PML. Medicines to treat PML are being developed and may be available in the near future. Outlook (Prognosis) PML is a life-threatening condition. Depending on how severe the infection is, up to one half of people diagnosed with PML die within the first few months. Talk to your provider about care decisions.Open ReferencesReferencesHirsch HH. Polyomaviruses. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 341.Tan CS, Koralnik IJ. JC, BK, and other polyomaviruses: progressive multifocal leukoencephalopathy (PML). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 144.