Epstein-Barr virus encephalitis and encephalomyelitis: MR findings

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.

Serial diffusion-weighted MR imaging findings in a patient with Epstein-Barr virus encephalitis

“…Since neuroimaging studies are normal in the majority of patients with EBV encephalitis, available reports of MRI abnormalities are limited but describe lesions that involve the basal ganglia [1][2][3], brainstem [4,5], thalamus [1,6], splenium of the corpus callosum [7], and cerebral cortex [1]. The distribution of signal abnormalities in our patient was primarily confined to the bilateral basal ganglia, consistent with the characteristic MRI findings of EBV encephalitis [1][2][3].…”

“…The distribution of signal abnormalities in our patient was primarily confined to the bilateral basal ganglia, consistent with the characteristic MRI findings of EBV encephalitis [1][2][3]. Differential diagnoses of the disorders that preferentially affect bilateral basal ganglia are extensive and include Japanese encephalitis, tick-borne encephalitis, anoxic encephalopathy, hypoglycemic encephalopathy, mitochondrial encephalopathy, carbon monoxide poisoning, Lyme encephalitis, Creutzfeldt-Jakob disease, Wilson disease, Huntington disease, and acute demyelinating encephalomyelitis (ADEM).…”

“…Sirs: Acute encephalitis is a serious neurological complication associated with Epstein-Barr virus (EBV) infection and its neuroimaging abnormalities have been infrequently reported [1]. We describe a patient with EBV encephalitis in whom serial diffusion-weighted MR imagings (DWI) showed reversible vasogenic edema in the bilateral basal ganglia along with a complete clinical recovery within a few weeks.…”

Epstein‐Barr virus encephalitis mimicking clinical and electroencephalographic characteristics of herpes simplex encephalitis

“…Interestingly, most cases in the literature are pediatric cases. In these pediatric cases the clinical picture was very similar to ours regarding seizures, psychosis [Shian and Chi, 1996] nevertheless lateralized epileptiform discharges were not present, at least not reported. The radiological findings differed from ours indicating the different susceptibility of the juvenile and adult brain to EBV infection.…”

Secondary neuropsychiatric manifestations caused by Epstein–Barr virus encephalitis in a new onset systemic lupus erythematosus patient

“…In one report about 30 Epstein-Barr virus encephalitis patients, 25 patients had a good outcome, 5 patients had sequelae, and no one died [12]. In another report about 20 Epstein-Barr virus encephalitis patients, 15 patients recovered completely, 3 ones had sequelae, and 2 ones died [13].…”