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Volume 353:1744-1746 October 20, 2005 Number 16
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Progressive Multifocal Leukoencephalopathy, Natalizumab, and Multiple Sclerosis

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To the Editor: According to the established definition of multiple sclerosis,1 the condition in the patient described by Kleinschmidt-DeMasters and Tyler (July 28 issue)2 should not have been diagnosed as multiple sclerosis. Apart from the unusual clinical findings, no oligoclonal bands were detected in two separate examinations of the cerebrospinal fluid, and repeated magnetic resonance imaging (MRI) scans obtained over the course of several years showed new and enlarging, but never enhancing, lesions. The most convincing argument against a diagnosis of multiple sclerosis is the neuropathology: no lesions that are characteristic for multiple sclerosis were detected. The patient described by . . . [Full Text of this Article]




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