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Epstein-Barr virus acute encephalomyelitis in a 13-year-old boy

Eugênio Grillo1, Ronaldo J M da Silva, Jorge H Barbato Filho

  • 1Department of Neurology, Joana de Gusmão Children's Hospital, Florianópolis, SC, Brazil.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|December 7, 2007
PubMed

Insights

A rare case of acute myelopathy and encephalopathy in a 13-year-old boy was linked to Epstein-Barr virus infection. Prompt treatment led to a full recovery, suggesting potential direct viral CNS involvement.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Epstein-Barr virus (EBV) is a common human herpesvirus.
  • EBV is known to cause infectious mononucleosis.
  • EBV is implicated in immune-mediated neurological disorders like acute disseminated encephalomyelitis (ADEM).

Observation:

  • A 13-year-old boy presented with acute myelopathy and encephalopathy.
  • Clinical and laboratory findings confirmed infectious mononucleosis due to EBV.
  • Cerebrospinal fluid analysis revealed Epstein-Barr virus DNA.

Findings:

  • The patient experienced cortical involvement on MRI.
  • Central nervous system (CNS) manifestations appeared shortly after infectious mononucleosis.
  • The presence of EBV DNA in CSF suggested a potential direct viral invasion of the CNS.
  • Acute myelopathy and EBV encephalitis are rarely reported together in children.

Implications:

  • This case highlights a rare presentation of EBV infection in the CNS.
  • It raises the possibility of direct EBV neuroinvasion beyond typical immune-mediated mechanisms.
  • Rapid diagnosis and pulse methylprednisolone therapy resulted in complete recovery.
  • Further research may elucidate the direct role of EBV in pediatric CNS disorders.

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