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[Encephalitis after acute Epstein-Barr virus infection].

G Riemer1, Ø Stenvik, O P Dahl

  • 1Nevrologisk avdeling, Namdal Sykehus 7800 Namsos.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|July 24, 2001
PubMed
Summary

Epstein-Barr virus (EBV) can cause severe encephalitis, even without typical infectious mononucleosis symptoms or specific cerebrospinal fluid findings. This highlights the need for vigilance in diagnosing EBV-related neurological complications.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Epstein-Barr virus (EBV) is a common human herpesvirus.
  • EBV infection is associated with a range of clinical manifestations, including infectious mononucleosis.
  • Severe neurological complications, such as encephalitis, can occur following EBV infection.

Observation:

  • This study reports on two male patients, aged 17 and 22, who developed encephalitis following acute primary EBV infection.
  • One patient presented with classic infectious mononucleosis symptoms and EBV-specific cerebrospinal fluid (CSF) findings.
  • The second patient lacked typical infectious mononucleosis signs and had negative CSF EBV polymerase chain reaction (PCR) results, despite similar encephalitis symptoms.

Findings:

  • Clinical features of encephalitis in both cases included memory deficits, personality changes, reduced consciousness, brainstem dysfunction, and seizures.

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  • Neuroimaging (CT and MRI) revealed involvement of the basal ganglia and limbic system in both patients.
  • Neither patient responded to acyclovir treatment, suggesting limited efficacy of this antiviral in severe EBV-related encephalitis.

    • Implications:

    • EBV can cause severe cerebral complications, including encephalitis, without overt signs of infectious mononucleosis or detectable EBV in CSF.
    • Diagnostic awareness for EBV encephalitis is crucial, even in the absence of typical prodromal symptoms or positive CSF viral markers.
    • Further research into the pathogenesis and treatment of EBV-related neurological disorders is warranted.