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Relapsing acute disseminated encephalomyelitis associated with chronic Epstein-Barr virus infection: MRI findings

H Shoji1, T Kusuhara, Y Honda

  • 1First Department (Neurology) of Internal Medicine, Kurume University School of Medicine, Japan.

Neuroradiology
|January 1, 1992
PubMed

Insights

A young woman experienced relapsing acute disseminated encephalomyelitis, potentially linked to chronic Epstein-Barr virus (EBV) infection. This neurological condition caused recurrent symptoms and distinct MRI abnormalities over a year.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disease of the central nervous system.
  • Epstein-Barr virus (EBV) is a common human herpesvirus often associated with infectious mononucleosis.
  • Chronic or persistent EBV infection can sometimes be linked to various neurological complications.

Observation:

  • A 25-year-old woman presented with fever, cervical lymphadenopathy, and neurological symptoms including CSF pleocytosis.
  • She exhibited persistent high serum antibodies to Epstein-Barr virus (EBV).
  • Initial MRI showed abnormalities in the right basal ganglia and left midbrain.

Findings:

  • The patient experienced a recurrence of symptoms one year later.
  • The diagnosis considered was relapsing acute disseminated encephalomyelitis associated with chronic EBV infection.
  • Recurrence was associated with new MRI abnormalities in the contralateral basal ganglia and right cerebral white matter.

Implications:

  • This case highlights a potential association between chronic Epstein-Barr virus infection and relapsing-ADEM.
  • Recurrent neurological episodes in the context of persistent EBV serology warrant thorough investigation.
  • Understanding such associations can aid in diagnosing and managing complex neurological disorders.

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