T2-weighted MRI with isolated brainstem PML (progressive multifocal leukoencephalopathy). Signal alterations in the brainstem and cerebellum (arrows). Image obtained in a 27-year-old patient with subacute clouded consciousness, double images, swallowing disturbances and tetraparesis. No supratentorial lesions demonstrable, oligoclonal bands negative, HIV and JC virus PCR positive. (Image courtesy Institute of Neuroradiology, University Essen)
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