Figure 4.

A summary of the clinical course of the diagnostic and therapeutic procedures with corresponding MR images. The timeline shown above represents the clinical course (24 months) after the first visit. Of note, punctate lesions in the deep white matter and internal capsule on FLAIR images gradually disappeared, and no new lesions have developed since the tapering-off of mycophenolate mofetil and the administration of mefloquine. The CSF was negative for JCV DNA at 11 months and has remained negative for the past 12 months. The ataxia has not worsened, and cognitive dysfunction has improved slightly. The patient has been stable for more than 18 months since the brain biopsy. JCV: JC virus, CSF: cerebrospinal fluid, MMSE: Mini Mental State Examination, FLAIR: fluid- attenuated inversion recovery