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Epstein-Barr virus myeloradiculitis and encephalomyeloradiculitis.
Arshad Majid1, Steven L Galetta, Charlene J Sweeney
1Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Brain : a Journal of Neurology
|February 9, 2002
Summary
Epstein-Barr virus (EBV) can cause diverse neurological syndromes, including myeloradiculitis and meningoencephalitis. Diagnosis involves detecting EBV DNA and antibodies in cerebrospinal fluid, indicating intrathecal synthesis.
Area of Science:
- Neurovirology
- Infectious Diseases
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus.
- Neurological manifestations of EBV infection are diverse and can affect the central and peripheral nervous systems.
Observation:
- This study analyzes four patients with EBV affecting the nervous system, presenting with various syndromes like myeloradiculitis and meningoencephalitis.
- Clinical presentations included stiff neck, altered mental status, weakness, and sensory loss.
- Cerebrospinal fluid (CSF) showed pleocytosis and elevated protein, with detectable EBV DNA and antibodies, suggesting intrathecal synthesis.
Findings:
- MRI revealed spinal cord and nerve root abnormalities in some cases, while others had normal brain and spinal cord imaging.
- EBV DNA was detected in CSF, differentiating it from other herpesviruses like CMV, HSV, and VZV.
- Reduced serum/CSF antibody ratios confirmed intrathecal antibody production specific to EBV.
Implications:
- EBV-associated neurological disease presents distinct clinical features compared to other herpesviral infections.
- While not fatal, EBV neurological infections can lead to residual deficits such as weakness and sensory loss.
- Further research is needed to elucidate the mechanisms of EBV-induced neurological damage and develop targeted therapies.