Refractory epilepsy following natalizumab associated PML

Abstract

Natalizumab treatment of multiple sclerosis (MS) is associated with a risk of developing progressive multifocal leukoencephalopathy (PML), a rare opportunistic viral demyelinating disease caused by reactivation of John Cunningham virus (JCV). Herein, we report a case of a 40-year-old woman who developed refractory temporal lobe epilepsy; one year after recovery form Natalizumab-induced PML. Localisation related epilepsy, which may be refractory in nature, as in this case report, is a potential chronic disabling complication of PML. Epilepsy in this context, likely reflects grey matter involvement, which may then act as cortical epileptogenic zone.

Keywords: Multiple sclerosis; Natalizumab; PML; Refractory epilepsy.