Article Text
Neurological picture
Progressive multifocal leucoencephalopathy with discrete involvement of pyramidal tract
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A 35 year old gentleman manifested with subacute onset progressive left hemiparesis, left facial weakness, and dysarthria of 1 month duration. While in hospital, he developed dysphagia, and oesophageal candidiasis was detected. His haemogram, serum biochemistry, and urine analysis were normal. He was seropositive for human immunodeficiency virus (HIV) by enzyme linked immunosorbent assay (ELISA) with CD4 count of 240 cells/cc and CD8 of 945 cells/cc. The magnetic resonance imaging (MRI) of brain revealed a non-enhancing lesion (hypointense on T1W and hyperintense on T2W and fluid attenuated inversion recovery (FLAIR) …