Transient global amnesia as a manifestation of Epstein-Barr virus encephalitis

Abstract

A 43-year-old man developed severe global amnesia with uncinate fits and a single generalised convulsion 10 days after a febrile infection. CSF pleocytosis and serological findings indicated an acute Epstein-Barr virus encephalitis. All of the symptoms cleared within 2 weeks except for occasional generalised seizures. This seems to be the first observation of Epstein-Barr virus encephalitis presenting predominantly as transient global amnesia.

Increased levels of neurotrophins in the cerebrospinal fluid of children with Epstein–Barr virus meningoencephalitis

“…32,[34][35][36] In accordance with these observations, for our two children with neuropsychiatric disorders, the increased intracerebral biosynthesis of BDNF and NGF induced by EBV infection might also be responsible for the prolonged alteration in mental status, as reported previously in the literature. [37][38][39] In conclusion, our study showed an early and strong BDNF and NGF over-expression in the CSF of children with viral ME, namely in patients with EBV-induced ME, in whom we also detected a significant correlation between increased levels of neurotrophins and the number of lymphocytes. The increased intracerebral biosynthesis of BDNF and NGF might also be the underlying molecular cause of the specific neuropsychiatric-related disorders observed in two children with EBV-induced ME.…”

“…3 Movement disorders indicative of extrapyramidal involvement, such as athetosis, Parkinson-like syndrome, and Sydenham-type chorea, have also been reported, while acute psychosis and transient global amnesia may be the only neurological manifestations in some cases of EBV-induced ME in children. [4][5][6] Several hypotheses to explain this particular neurological virulence of EBV infection in children have been advocated, including down-regulation of type 1 interferon expression, apoptosis, and hyperinduction of proinflammatory cytokines. 7,8 It has also been reported that neurotrophin up-regulation plays a key role in the inflammatory host response after EBV-induced ME.…”

Unusual Neurologic Manifestations Associated with Epstein-Barr Virus Infection.

“…migraine and epilepsy (14). To our knowledge, TGAdue to encephalitis has been reported only once, by Pommer et al (15). Their patient suffered EBVencephalitis which gave rise to uncinate fits and generalized convulsions as well.…”

Neuropsychological sequelae of acute-onset sporadic viral encephalitis

“…The outcome is usually considered favourable, with the majority of patients recovering completely (Silverstein et al, 1972) but in children at least the acute manifestations have included focal symptoms in one third of the cases (Domachowske et al, 1996). One report describes a 43-year-old patient who developed transient global amnesia along with epileptic seizures following an EBV infection (Pommer, Pilz, & Harrer, 1983). The patient was treated with anticonvulsant medications, gradually regained memory functions, and was subsequently released to return to work one month after EBV infection.…”