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Persistent preceding focal neurologic deficits in children with chronic Epstein-Barr virus encephalitis

J M Caruso1, G A Tung, G G Gascon

  • 1Department of Pediatric Neurology, Children's National Medical Center, Washington, DC 20010, USA. jcaruso@cnmc.org

Journal of Child Neurology
|February 24, 2001
PubMed

Insights

Chronic Epstein-Barr virus encephalitis can cause lasting cognitive and neurological issues in children, contrary to its usual self-limiting nature. This study highlights persistent deficits and MRI abnormalities in five pediatric cases.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neurovirology

Background:

  • Epstein-Barr virus (EBV) encephalitis is typically self-limiting with minimal long-term effects.
  • Persistent neurological deficits following EBV encephalitis in children remain poorly described.

Observation:

  • Five children presented with persistent cognitive and focal neurological deficits.
  • Clinical manifestations included aphasia, apraxia, behavioral changes, cognitive decline, seizures, and obsessive-compulsive disorder.
  • Magnetic resonance imaging revealed various T2-weighted abnormalities in affected children.

Findings:

  • All patients exhibited elevated EBV serum titers, with four testing positive for EBV in cerebrospinal fluid via PCR.
  • Methylprednisolone treatment yielded minimal improvement and no MRI changes in three patients.
  • EBV encephalitis can manifest insidiously with chronic neurological symptoms.

Implications:

  • EBV encephalitis should be considered in the differential diagnosis of acute or chronic neurological illnesses in children.
  • This study expands the understanding of EBV encephalitis beyond its typical self-limiting course.
  • Recognizing chronic EBV encephalitis is crucial for timely diagnosis and management of persistent neurological deficits in pediatric populations.

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