10 January 2022
: Case report 
Clinically Isolated Brainstem Progressive Multifocal Leukoencephalopathy: Diagnostic Challenges
Mistake in diagnosis
Faisal Khan
12ABCDEF*, Neha Sharma 2ABCDEF, Moin Ud Din 2ABCDEF, Ijeoma Gloria Akabalu3ABCDEF
DOI: 10.12659/AJCR.935019
Am J Case Rep 2022; 23:e935019
Table 1. Differential diagnoses of acute brainstem syndrome.
| Etiology | Diagnosis |
|---|---|
| Immune-mediated | Neuromyelitis optica spectrum disorders (NMOSD) [,,]5 |
| Multiple sclerosis (MS) [,,]5 | |
| Bickerstaff brainstem encephalitis (BBE) [,]5 | |
| Myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD) [,,]5 | |
| Infectious | Rhombencephalitis () []5 |
| Human immunodeficiency virus (HIV) encephalopathy []14 | |
| Progressive multifocal leukoencephalopathy (John Cunningham virus) (PML) []27 | |
| Inflammatory | Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) [,]26 |
| Neurosarcoidosis []26 | |
| Neuro systemic lupus erythematosus (SLE) []26 | |
| Acute disseminated encephalomyelitis (ADEM) [,]5 | |
| Neuro Sjogren’s []26 | |
| Neuro Bechet’s []27 | |
| Metabolic | Wilson’s disease []28 |
| Leigh’s syndrome []5 | |
| Central pontine myelinolysis/osmotic demyelination syndrome [,]5 | |
| Vascular | Vertebrobasilar ischemic syndrome []29 |
| Posterior reversible encephalopathy syndrome (PRES) []30 | |
| Toxic | Heroin []28 |
| Cyclosporin A encephalopathy []28 | |
| Neoplasms/paraneoplastic | Brainstem glioma []5 |
| Diffuse large B cell lymphoma []27 | |
| Anti Hu, Ma2, Ri, KLH, LUZP4 []27 |