Multifocal necrotizing leukoencephalopathy (MNL)
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Multifocal necrotizing leukoencephalopathy (MNL). There is multifocal microscopic white matter necrosis. Fully referenced neurology checklist.
Pathology
- There is multifocal microscopic white matter necrosis
- This has a predilection for the pontocerebellar decussation and pontine white matter tracts
- It usually develops in people with immunosuppression
Medical risk factors
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Drug-induced risk factors
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Histology
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References
- Anders KH, Becker PS, Holden JK, et al. Multifocal necrotizing leukoencephalopathy with pontine predilection in immunosuppressed patients: a clinicopathologic review of 16 cases. Hum Pathol 1993; 24:897-904.
- Mah V, Nelson L, Vinters HV. Focal pontine leukoencephalopathy in a patient with the Shwachman-Diamond syndrome. Can J Neurol Sci 1987; 14:608-610.
- O'Gara MA, Dharia S, Hilton D, Gutowski NJ. Multifocal necrotising leucoencephalopathy following Salmonella infection in an immunocompetent patient. Pract Neurol 2018; 18:156-158.
- Sharshar T, Gray F, Poron F, Raphael JC, Gajdos P, Annane D. Multifocal necrotizing leukoencephalopathy in septic shock. Crit Care Med 2002; 30:2371-2375.
- Marker DF, Kofler JK, Mettenburg JA, Agha ME, Wiley CA. Multifocal necrotizing leukoencephalopathy with preferential microglia toxicity in a patient treated with chimeric antigen receptor t-cells and review of the literature. J Neuropathol Exp Neurol 2020; 79:1115-1121.
