A Rare Case of Adult Acute Disseminated Encephalomyelitis Associated with Primary Epstein-Barr Virus Infection

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated demyelinating disease of the central nervous system (CNS).
• While more common in children, ADEM can occur in adults, often triggered by infections or vaccinations.
• Epstein-Barr virus (EBV) infection, commonly causing infectious mononucleosis, is an infrequent cause of ADEM.

Purpose of the Study:

• To report a rare case of ADEM secondary to a primary Epstein-Barr virus infection in a 22-year-old male.
• To emphasize the atypical presentation of both infectious mononucleosis and ADEM in this age group.

Main Methods:

• Case report detailing the clinical presentation, diagnostic workup, and management of a young adult male with ADEM.
• Review of diagnostic criteria for ADEM, focusing on the role of neuroimaging and clinical history.

Main Results:

• The patient presented with symptoms consistent with infectious mononucleosis, followed by neurological deficits indicative of ADEM.
• Cerebral magnetic resonance imaging (MRI) was crucial in confirming the diagnosis of ADEM, despite initial normal findings on other scans.
• The case underscores the possibility of ADEM developing secondary to EBV infection in adults.

Conclusions:

• ADEM is a rare CNS disorder that can occur in adults, often post-infection or post-vaccination.
• Clinical evaluation should prioritize identifying recent infectious or vaccination history.
• A normal cerebral scan does not exclude ADEM; MRI is essential for diagnosis.