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

Case Report: Epstein–Barr Virus Encephalitis Complicated With Brain Stem Hemorrhage in an Immune-Competent Adult

“…As described in previously reported cases of EBV encephalitis (6,(17)(18)(19), CSF pressure, mononuclear cell count, and protein content in the CSF increased after infection onset, but the glucose and Cllevels were normal which was also observed in this case. EBV encephalitis has no typical symptoms, and the results of CSF examination are similar to those for cerebral tuberculosis (4,12).…”

“…In most cases, EBV encephalitis is accompanied by liver and spleen enlargement (15,27). However, some patients may not have an enlarged liver and spleen (19), which provides a challenge for diagnosing EBV encephalitis. In the early stage of the disease, CT does not show abnormalities, and MRI examinations often show increased signal intensity on T2weighted imaging sequences on both temporal lobes (12,15,19,28).…”

“…However, some patients may not have an enlarged liver and spleen (19), which provides a challenge for diagnosing EBV encephalitis. In the early stage of the disease, CT does not show abnormalities, and MRI examinations often show increased signal intensity on T2weighted imaging sequences on both temporal lobes (12,15,19,28). In the present case, the CT images did not show any abnormalities, except for the CT scan taken later that showed cerebral hemorrhage.…”

“…EBV encephalitis usually occurs in the brain stem (9,12,16,17), cerebellum (9), thalamus (18), basal ganglia (12), optic nerve (8,12), and spinal cord (12). The most frequent clinical features of EBV encephalitis are mental deterioration (19), reversible parkinsonism (20,21), vasculitis (4,9,15), and bleeding (3,9).…”

Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study: response to a “letter to the editor”

“…Consequently, we consider that no definite restriction on the diffusion study in the early phase of the RSV-related encephalitis may provide evidence for the reversibility of the lesion, which is not progressed to cytotoxic edema and it is associated with favorable outcomes [4,5].…”