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[Epstein-Barr virus-associated subacute sensorimotor neuropathy with multiple cerebellar microbleeding: a case
Mayumi Furuya1, Satoru Oji1, Kohei Sugimoto1
1Department of Neurology, Saitama Medical Center, Saitama Medical University.
Rinsho Shinkeigaku = Clinical Neurology
|July 24, 2022
Summary
Epstein-Barr virus (EBV) reactivation can cause subacute sensorimotor neuropathy, presenting as limb weakness and visual disturbances. This case highlights EBV-associated vasculitis and demyelinating neuropathy, successfully treated with corticosteroids.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Subacute sensorimotor neuropathy can be associated with various infections.
- Epstein-Barr virus (EBV) is a common herpesvirus with diverse clinical manifestations.
- Neurological complications of EBV reactivation are rare but can be severe.
Observation:
- An 82-year-old male presented with diplopia and gait disturbance due to limb weakness.
- Cervical lymph node biopsy revealed numerous EBV-positive cells, and EBV-DNA was detected in blood.
- Nerve conduction studies indicated mixed axonal damage and demyelination.
Findings:
- Brain MRI showed cerebellar microbleeds, suggesting EBV-related vasculitis.
- Cerebrospinal fluid EBV-PCR was negative.
- The patient's neuropathy likely resulted from a combination of vasculitic and immune-mediated demyelinating processes.
Implications:
- This case highlights EBV reactivation as a potential cause of complex neurological syndromes.
- Early diagnosis and corticosteroid therapy can lead to significant recovery in EBV-associated neuropathies.
- Understanding the pathogenesis of EBV-related neurological disorders is crucial for effective management.
