Demyelinating Disease of the Brain in Chronic Lymphatic Leukemia

Certain neurological complications appearing during the course of leukemia and related disorders are not infrequent. The occurrence of cerebral hemorrhage in the leukemias, often as a terminal event, is usually easily recognized. Involvement of the spinal epidural space by Hodgkin's disease and lymphosarcoma, resulting in paraplegia, is also a relatively common phenomenon. Focal symptomatology developing as a result of direct invasion of the brain by leukemic or lymphomatous tissue is quite uncommon; however, even this complication has been reported more frequently recently, especially in the acute leukemias managed by modern chemotherapeutic methods.¹ An interesting but less widely known complication of the lymphomas is a demyelinating disease of the brain, recently described by Astrom, Mancall, and Richardson.²This disease, termed "progressive multifocal leukoencephalopathy," is manifested clinically by signs of diffuse brain involvement progressing rapidly, without remission, to a fatal termination within weeks or months. It has occurred predominantly in