Progressive multifocal leukoencephalopathy (PML) is a progressive lethal demyelinating disease
of the brain, caused by JC virus. Reactivation of JC virus due to reduction of cellular immunity
especially in setting of AIDS, is the commonest underlying cause. PML has classically been described
in individuals with profound cellular immunosuppression such as patients with AIDS, haematological
malignancies, organ transplant recipients or those treated with immunosuppressive or immunomodulatory
medications for autoimmune diseases. Rarely it has also been diagnosed in cases with no or minimal
immunosuppression. Here, we report a 50 year-old man who presented with sudden onset multiple
neurologic defi cits. Neuroimaging, histopathology, and virology studies confi rmed the diagnosis of
PML. We could not however demonstrate any underlying immunodefi ciency state. Our case suggests
that absence of immunodefi ciency does not exclude the possibility of PML and should be considered
in immunocompetent patients with a typical clinical course and neuroimaging fi ndings.