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Acute cerebellar syndrome in infectious mononucleosis: documentation of two cases with Epstein-Barr virus infection
Abstract:
Acute cerebellar ataxia has been described occasionally with infectious mononucleosis. Two additional cases are reported with serologic identification of Epstein-Barr virus (EBV) infection in blood and cerebrospinal fluid. As with previously described cases, the outcome was benign, and examination and laboratory studies did not indicate diffuse neurologic involvement. Visual and brainstem auditory-evoked responses were normal. Electroencephalograms (EEG) demonstrated 14 and 6 per second positive spikes in both patients. This pattern is considered a normal variant and has been recorded from depth electrodes and reported with deep midline lesions. These cases support the prognosis of benign cerebellar involvement in infectious mononucleosis and suggest that evidence of EBV infection be sought in patients with acute ataxia. The significance of 14/sec and 6/sec positive EEG spikes is uncertain.
Insights
Acute cerebellar ataxia can occur with infectious mononucleosis. Identifying Epstein-Barr virus (EBV) infection supports a benign prognosis for this neurological complication.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Acute cerebellar ataxia is an uncommon neurological complication associated with infectious mononucleosis.
- Epstein-Barr virus (EBV) is the primary cause of infectious mononucleosis.
Observation:
- Two new cases of acute cerebellar ataxia in patients with confirmed EBV infection are presented.
- Neurological examinations and laboratory tests revealed no signs of diffuse neurological involvement.
- Electroencephalograms (EEG) showed 14 and 6 per second positive spikes, a pattern considered a normal variant.
Findings:
- Serologic tests confirmed EBV infection in both blood and cerebrospinal fluid.
- Visual and brainstem auditory-evoked responses were normal in both patients.
- The clinical course was benign, consistent with previously reported cases.
Implications:
- These findings support the generally benign prognosis of cerebellar involvement in EBV-associated infectious mononucleosis.
- Clinicians should consider testing for EBV infection in patients presenting with acute ataxia.
- The clinical significance of 14/sec and 6/sec positive EEG spikes in this context remains uncertain.