Fig. 1

Overview on paraclinical findings and treatment decisions. The figure chronologically displays treatment decisions (first row), lymphocyte counts (second row), laboratory (third row), and MRI findings (fourth and fifth row). At baseline, only very few punctate milky way-like lesions were detectable (circle). After recovery of lymphocytes, new punctate milky way-like lesions developed (circle), and again ceased after corticosteroid pulse therapy (circle). The initial PML lesion in the left hemisphere was stable over time (see Fig. 2). Unfortunately, new MS-like lesions developed after discontinuation of fingolimod (white arrows). Anti-JCV antibody detection and quantification was performed at Unilabs Copenhagen, Denmark. JCV-DNA-PCR from CSF was performed at Institute of Virology, University Clinic of Duesseldorf.