[Magnetic resonance of the brain in encephalitis due to Epstein-Barr virus]

Encephalitis due to Epstein-Barr virus (EEBV) is rare and the debate on possible pathogenic mechanisms has remained open in the absence of structural changes in brain images and discrepancies in serology and viral culture results. We describe an EEBV case in which magnetic resonance images in T1 and T2 potentiated sequences were normal, although intense meningeal captation and a destructive parenchymatous lesion could be observed after administration of gadolinium. These findings suggest direct infiltration of the central nervous system by the virus as well as a meningeal infiltrative type reaction, supporting the hypothesis that the pathogenic mechanisms involved is invasive rather than infectiously or immunologically mediated. The pattern of involvement seen in EEBV by magnetic resonance is different from that of other forms of viral encephalitis.