Neurological complications of acute and persistent Epstein‐Barr virus infection in paediatric patients

Abstract

Neurological complications of Epstein-Barr virus (EBV) have been reported almost exclusively in the course of acute primary infections. The role of EBV in paediatric neurological disease was investigated prospectively over a 2-year period, searching for acute primary, chronic, and reactivated EBV infections. Active EBV infections were diagnosed in 10/48 patients, including two with acute primary EBV infections (cranial neuritis and cerebellitis), one with chronic active infection (T/NK cell lymphoma with cranial neuritis), and seven with reactivated infections. Among these seven patients, three showed "Alice in Wonderland" syndrome, one facial nerve palsy, one progressive macrocephaly, and two prolonged encephalitic illness. The prognosis was good except for the patient with lethal T/NK cell lymphoma and the two girls with encephalitic illness. Despite steroid treatment, these girls suffered prolonged cognitive impairment and epileptic seizures. Both developed left-sided hippocampal atrophy, and one of them hippocampal sclerosis. Like primary infections, reactivated EBV infections cause neurological complications in a considerable number of paediatric patients, lead to serious long-term complications, and may contribute to the pathogenesis of hippocampal lesions.

Increased seroprevalence of Toxoplasma gondii in a population of patients with Bell’s palsy: a sceptical interpretation of the results regarding the pathogenesis of facial nerve palsy

“…Facial nerve palsy has been reported in patients with reactivated EBV infection [4,8,9]. On the contrary, in the study conducted by Morgan [19] the prevalence of IgM antibodies to EBV did not differ between patients and controls and the higher rate of IgG seropositivity in patients was considered to be of doubtful significance.…”

“…Facial nerve palsy has been reported in patients with reactivated EBV infection [4,8,9]. Unlike EBV which has already been addressed for its possible role in the pathophysiology of Bell's palsy, the seroprevalence of Toxoplasma gondii antibodies in a population of patients with facial nerve palsy has not been investigated yet.…”

Inmunohistoquímica en un caso de encefalitis por virus de Epstein Barr

“…Los estudios histológicos del SNC en la encefalitis por VEB han contribuido para comprender su patogénesis. Los principales patrones histopatológicos de la encefalitis asociado al VEB son: EMDA, encefalitis con infiltrados mononucleares peri-vasculares y encefalitis hemorrágica edematosa [13][14][15] .…”

Bilateral symmetrical basal ganglia and thalamic lesions in children: an update (2015)

“…Of all the members of the Herpesviridae family, EBV shows the most characteristic tropism for the deep gray nuclei. T2 hyperintensity in the bilateral basal ganglia and thalami is often identified in EBV encephalitis [25][26][27]. Associated anomalies include the cerebral hemispheres, brainstem, and cerebellum [28].…”