How is PML diagnosed?

Many of the symptoms of PML are similar to those seen with other HIV-related diseases (e.g., toxoplasmosis, cryptococcal meningitis, and lymphoma of the central nervous system). Thus, it is important to determine the exact cause of these symptoms so that the correct treatment can be started.

The most accurate way to diagnose PML is by conducting a brain biopsy. To do this, a surgeon will need to remove a small piece of brain tissue and send it to a lab for analysis. However, a brain biopsy can be risky, especially for those with compromised immune systems. It is also possible to diagnose PML by analyzing magnetic resonance imaging (MRI) scans of the brain and/or by looking for the JC virus in the fluid surrounding the spinal column. This requires a spinal tap – a needle inserted into the lower back to drain spinal fluid so that it can be analyzed.

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