Epstein-Barr virus acute encephalomyelitis in a 13-year-old boy

Grillo, Eugênio; Silva, Ronaldo J. M. da; Filho, Jorge H. Barbato

doi:10.1016/j.ejpn.2007.10.016

Cited by 11 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both had EBV titers detected in the CSF by PCR. The remaining cases of ADEM linked with EBV are largely comprised of individual case reports and small studies [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81].…”

Section: Viruses Common In Adem and Msmentioning

confidence: 99%

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

et al. 2014

View full text Add to dashboard Cite

Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are demyelinating disorders affecting the central nervous system. An autoimmune aetiology has been proposed for both. ADEM principally affects adolescents following acute infection by a variety of pathogens and has also been reported to occur following vaccination. ADEM typically resolves following medical treatment, whereas MS follows a more relapsing and remitting course. The pathogenesis of MS remains unclear, but it is thought that a combination of infectious and non-infectious environmental factors and host genetics act synergistically to cause disease. A variety of viruses, including Epstein Barr virus, cytomegalovirus, herpes simplex virus and varicella zoster virus, have been implicated as possible infectious triggers. The similar clinical and pathological presentation of ADEM and MS presents a diagnostic challenge for distinguishing ADEM from a first episode of MS. Some cases of ADEM progress to MS for reasons that are not currently clear. This review examines the evidence for infectious agents as triggers for ADEM progressing to MS and suggests potential methods that may facilitate identification of infectious agents that may be responsible for the pathogenesis of ADEM to MS.

show abstract

Section: Viruses Common In Adem and Msmentioning

confidence: 99%

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A wide range of neurological manifestations has been described during EBV infection in pediatric and adult patients, whose main features are reported in Table 1 . They include mild symptoms such as headache and drowsiness or more severe manifestations including seizures, ataxia or encephalitis [ 3 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Post-Infectious Acute Cerebellar Ataxia Treatment, a Case Report and Review of Literature

et al. 2023

View full text Add to dashboard Cite

Background: infectious mononucleosis is very common during childhood and neurological manifestations are extremely rare. However, when they occur, an appropriate treatment must be undertaken to reduce morbidity and mortality as well as to ensure appropriate management. Methods: we describe the clinical and neurological records of a female patient with post-EBV acute cerebellar ataxia, whose symptoms rapidly resolved with intravenous immunoglobulin therapy. Afterwards, we compared our results with published data. Results: we reported the case of an adolescent female with a 5-day history of sudden asthenia, vomiting, dizziness, and dehydration, with a positive monospot test and hypertransaminasemia. In the following days, she developed acute ataxia, drowsiness, vertigo, and nystagmus with a positive EBV IgM titer, confirming acute infectious mononucleosis. The patient was clinically diagnosed with EBV-associated acute cerebellitis. A brain MRI showed no acute changes and a CT scan showed hepatosplenomegaly. She started therapy with acyclovir and dexamethasone. After a few days, because of her condition’s deterioration, she received intravenous immunoglobulin and demonstrated a good clinical response. Conclusions: although there are no consensus guidelines for the treatment of post-infectious acute cerebellar ataxia, early intervention with intravenous immunoglobulin might prevent adverse outcomes, especially in cases that do not respond to high-dose steroid therapy.

show abstract

“…A seasonal variation of ADEM frequency (with peaks in winter and spring) supports its infectious etiology [10,15]. The most frequent infections involved are viral and related to the upper respiratory tract, such as measles [14,16], mumps [2,[17][18][19], rubella [2], varicella [2,14], influenza [5,20], and infectious mononucleosis [21,22]. Also enterovirus [23], coronavirus [24], human immunodeficiency virus [2], herpes simplex virus [25], cytomegalovirus [22], and hepatitis A virus [26,27] have been associated with ADEM.…”

Section: A Complex Bind Of Infection-triggered Autoimmune Phenomena Amentioning

confidence: 99%

A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children

Esposito

Pietro

Madini

et al. 2015

Autoimmunity Reviews

View full text Add to dashboard Cite

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that involves multifocal areas of the white matter, rarely the gray matter and spinal cord, mainly affecting children and mostly occurring 1-2weeks after infections or more rarely after vaccinations. Though a specific etiologic agent is not constantly identified, to evaluate carefully patient's clinical history and obtain adequate samples for the search of a potential ADEM causal agent is crucial. In the case of a prompt diagnosis and adequate treatment, most children with ADEM have a favorable outcome with full recovery, but in the case of diagnostic delays or inappropriate treatment some patients might display neurological sequelae and persistent deficits or even show an evolution to multiple sclerosis. The suspicion of ADEM rises on a clinical basis and derives from systemic and neurologic signs combined with magnetic resonance imaging of the central nervous system. Other advanced imaging techniques may help an appropriate differential diagnosis and definition of exact disease extension. Although there is no standardized protocol or management for ADEM, corticosteroids, intravenous immunoglobulin, and plasmapheresis have been successfully used. There is no marker that permits to identify the subset of children with worse prognosis and future studies should try to detect any biological clue for prevision of neurologic damage as well as should optimize treatment strategies using an approach based on the effective risk of negative evolution.

show abstract

Epstein-Barr virus acute encephalomyelitis in a 13-year-old boy

Cited by 11 publications

References 22 publications

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

Post-Infectious Acute Cerebellar Ataxia Treatment, a Case Report and Review of Literature

A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children

Contact Info

Product

Resources

About