Nerve-conduction tests demonstrating axonal neuropathy can confirm the diagnosis. The possibility of vitamin B12 Management consists of dose reduction or discontinuation of any potentially offending agents. CT and MRI reveal lesions with ring enhancement. Lesions are often multiple with associated mass effect involving the frontal and parietal lobes and basal ganglia. Characteristic CT or MRI findings and positive serologic results are indications for empirical therapy.
Definitive diagnosis is by brain biopsy.
Progressive multifocal leukoencephalopathy Reactivation of latent JC virus results in progressive multifocal leukoencephalopathy. Clinical features of encephalitis include rapidly progressive confusion, delirium, apathy, and focal neurologic deficits. Manifestations may include headaches, mental status changes, seizures, and focal neurologic signs and symptoms.