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Acute disseminated encephalomyelitis following infectious mononucleosis

Hamid R Bahadori1, Virginia C Williams, Robert P Turner

  • 1Medical University of South Carolina, Charleston, SC 29425, USA. bahadori@musc.edu

Journal of Child Neurology
|July 11, 2007
PubMed

Insights

Epstein-Barr virus infection can trigger acute disseminated encephalomyelitis (ADEM) months later. This case highlights a delayed neurological complication following a common viral illness.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Epstein-Barr virus (EBV) is a common human herpesvirus.
  • EBV infections can rarely lead to neurological complications.
  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.

Observation:

  • A 17-year-old female presented with seizures, visual changes, and altered mental status two months post-EBV infection.
  • MRI revealed white matter changes consistent with ADEM, predominantly in posterior cerebral artery territories.
  • No radiological evidence of vasculitis was observed.

Findings:

  • Laboratory tests confirmed EBV infection and were consistent with postinfectious ADEM.
  • The patient's neurological symptoms improved with high-dose corticosteroids and intravenous immunoglobulin therapy.
  • This case suggests a potential delayed onset of ADEM following EBV infection.

Implications:

  • EBV should be considered as a potential trigger for late-onset ADEM.
  • Understanding the immunopathogenesis of post-EBV ADEM is crucial for timely diagnosis and treatment.
  • This case expands the spectrum of neurological sequelae associated with Epstein-Barr virus.

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