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Epstein-Barr virus encephalitis and encephalomyelitis: MR findings
1Department of Pediatrics, Tao-Yuan Veterans Hospital, No. 100, Sec 3, Cheng-Kung Rd, City of Tao-Yuan, Taiwan, ROC.
Abstract:
The purpose of this project is to investigate the clinical and brain MR characteristics of Epstein-Barr virus (EBV) encephalitis and encephalomyelitis. Clinical and 30 MR findings of 29 patients with EBV encephalitis or encephalomyelitis were retrospectively reviewed. Patients included 24 with encephalitis, 3 with encephalomyelitis, and 2 with brain-stem encephalitis. Altered consciousness, seizures, visual hallucination, and acute psychotic reaction were the common presentations. Eight patients had positive MR findings. These included T2 prolongation over gray and white matter, periventricular leukomalacia, and brain atrophy. Transient T2 prolongation over gray and white matter was found in one patient. Our results indicate that EBV encephalitis and encephalomyelitis have a wide range of both clinical and MR findings. The MR lesions may disappear in a short period, so the timing for the MR scan may be critical.
Insights
Epstein-Barr virus (EBV) encephalitis and encephalomyelitis present with diverse clinical and brain MR findings. Lesions may resolve quickly, making timely MRI scans crucial for diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Epstein-Barr virus (EBV) can cause serious neurological complications.
- Encephalitis and encephalomyelitis are inflammatory conditions affecting the brain and spinal cord.
Purpose of the Study:
- To investigate the clinical and brain magnetic resonance (MR) imaging characteristics of EBV-associated encephalitis and encephalomyelitis.
Main Methods:
- Retrospective review of clinical and MR findings in 29 patients diagnosed with EBV encephalitis or encephalomyelitis.
- Categorization of patients into encephalitis, encephalomyelitis, and brain-stem encephalitis groups.
Main Results:
- Common clinical presentations included altered consciousness, seizures, visual hallucinations, and acute psychotic reactions.
- Eight patients (27.6%) showed positive MR findings, such as T2 prolongation in gray and white matter, periventricular leukomalacia, and brain atrophy.
- One patient exhibited transient T2 prolongation, highlighting the dynamic nature of MR lesions.
Conclusions:
- EBV encephalitis and encephalomyelitis exhibit a broad spectrum of clinical and MR imaging manifestations.
- The transient nature of MR lesions underscores the critical importance of scan timing for accurate diagnosis.