Narrative review outlines diagnostic framework for PML in immunocompromised patients.

This is a narrative review that proposes a diagnostic framework for progressive multifocal leukoencephalopathy (PML) in immunocompromised individuals, aiming to differentiate it from common mimics in clinical practice. The authors synthesize key arguments for timely recognition and expedited diagnosis, emphasizing clinical and radiographic patterns. The review does not report pooled effect sizes or trial-level data, as it is a qualitative synthesis.

The authors note significant limitations, including the low incidence of PML, which leads to a lack of clinical familiarity, diverse clinical manifestations, and radiographic overlap with other disorders. These factors complicate diagnosis and are central to the review's discussion.

The practice relevance is to aid neurologists in timely recognition and expedited diagnosis. The review explicitly states that novel and experimental therapies are beyond its scope. No specific study populations, interventions, comparators, or adverse events are described, as these details are not reported in the source.

Overall, the framework is presented as a clinical aid, but its application is constrained by the inherent challenges of PML diagnosis. The authors' arguments are qualitative and based on clinical experience and existing literature, not new empirical data.