Progressive Multifocal Leukoencephalopathy Misdiagnosed as a Stroke

Progressive multifocal leukoencephalopathy (PML) is rare and can be challenging to diagnose. Symptoms can be varied and can mimic stroke phenotypes. Physicians must hold a high index of suspicion in patients with significant PML risk factors (including HIV/AIDS, immunosuppression, lymphoproliferative malignancies and chemotherapy/monoclonal antibody therapies) presenting with progressive neurological symptoms. Here, we describe a 63‐year‐old man who presented with left‐sided weakness, apraxia and neglect on a background of subtle cognitive decline. He had a past medical history of recurrent follicular lymphoma with chemotherapy. He was initially diagnosed as a stroke but deteriorated further and ultimately received a diagnosis of PML. Earlier recognition of this condition will help to facilitate research into this disease.