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

Chadaide, Zoltán; Vörös, Erika; Horváth, Szatmár

doi:10.1002/jmv.21327

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…Ours is the first reported instance of EBV encephalitis presenting with BIPLEDs in EEG. The presence of PLEDs in EEG in EBV encephalitis has been reported in a teen and an adult, which resolved on recovery from the illness 7 8. This clinical, EEG and MRI picture closely mimics HSE and requires a high degree of suspicion for proper diagnosis.…”

Section: Discussionmentioning

confidence: 84%

Bilateral independent periodic lateralised epileptiform discharges at presentation followed by rapid recovery: novel observations from a case of Epstein-Barr virus encephalitis

Iyer¹,

Ramalingam

Akhtar

et al. 2019

BMJ Case Rep

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Bilateral independent periodic lateralised epileptiform discharges (BIPLEDs) in electroencephalograms (EEGs) are commonly caused by anoxic encephalopathy and central nervous system infections. They are associated with coma and high mortality and are thus markers of poor prognosis. We present a case of encephalitis who presented with BIPLEDs in EEG. Though the clinical, EEG and MRI features closely resembled herpes simplex encephalitis, further investigations proved it to be Epstein-Barr virus (EBV) encephalitis. Despite the presence of BIPLEDs in the EEG, the patient had a rapid clinical response to therapy with acyclovir. We emphasise that BIPLEDs may not always indicate poor prognosis especially in the setting of EBV encephalitis.

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Section: Discussionmentioning

confidence: 84%

Bilateral independent periodic lateralised epileptiform discharges at presentation followed by rapid recovery: novel observations from a case of Epstein-Barr virus encephalitis

Iyer¹,

Ramalingam

Akhtar

et al. 2019

BMJ Case Rep

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“…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

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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.

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“…Aciclovir, ganciclovir and valganciclovir have each been successfully used in a variety of clinical settings for the treatment of EBV infections [9][10][11][12]. Ganciclovir has been shown to decrease the quantitative EBV PCR in the CSF of HIV-infected patients, but this has not been correlated with clinical outcomes [13].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Epstein–Barr Virus Encephalitis in the Setting of HIV-Associated Neurocognitive Disorder: A Diagnostic and Therapeutic Challenge

et al. 2013

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We report a challenging case of HIV-associated neurocognitive disorder with superimposed Epstein-Barr virus (EBV) encephalitis. The patient presented with an abnormal MRI brain scan, and EBV DNA that was detected in the cerebrospinal fluid and brain biopsy, which also demonstrated histopathological findings consistent with the diagnosis. This occurred on the background of a 12-month period of gradual cognitive decrease secondary to HIV-associated dementia. Invasive testing was required to reach the diagnosis in this case, highlighting the importance of thorough investigation of neurological impairment in HIV-positive patients. Clinicopathological recovery was achieved through optimization of antiretroviral therapy and use of valganciclovir.

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

Cited by 12 publications

References 14 publications

Bilateral independent periodic lateralised epileptiform discharges at presentation followed by rapid recovery: novel observations from a case of Epstein-Barr virus encephalitis

Bilateral independent periodic lateralised epileptiform discharges at presentation followed by rapid recovery: novel observations from a case of Epstein-Barr virus encephalitis

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

Successful Treatment of Epstein–Barr Virus Encephalitis in the Setting of HIV-Associated Neurocognitive Disorder: A Diagnostic and Therapeutic Challenge

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