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SUMMARY: Özbek O, Koç O, Paksoy Y, Aydin ?, Nayman ?. Epstein-Barr virus encephalitis: findings of MRI, MRS, diffusion and perfusion. Turk J Pediatr 2011; 53: 680-683
Epstein-Barr virus is an infection that is known as infectious mononucleosis. Even though the central nervous system is not a primary region of involvement of this disease, neurological complications are reported rarely. In this case report, we evaluated a 15-month-old male who presented to the pediatric neurology clinic due to high fever and a neurologic attack. His serological tests and radiological examinations (magnetic resonance imaging (MRI), MR spectroscopy (MRS), diffusion-weighted imaging (DWI) and MR perfusion) were consistent with Epstein-Barr virus encephalitis, which is a very rare complication of infectious mononucleosis. Additionally, we discuss the MRI, MRS, DWI and MR perfusion findings of our case, which were different from other cases reported in the literature.
Key words: encephalitis, Epstein-Barr virus, magnetic resonance spectroscopy.
Epstein-Barr virus (EBV) is a double-stranded DNA virus from the herpes virus family that is known as a pathogen of infectious mononucleosis (IM). IM is a benign self-limited disease that has a clinical course with fever, pharyngitis, lymphadenopathy, and hepatomegaly. Guillain-Barré syndrome, transverse myelitis, meningitis/encephalitis, and cranial nerve paralyses are some of the rarely reported neurological complications, with an incidence of 0.4% to 7.2>%l. Central nervous system (CNS) involvement may be the only sign of IM in some cases. In this case report, we evaluated a 15-month-old male who presented to the pediatric neurology clinic due to high fever and a neurologic attack. His serological tests and radiological examinations [magnetic resonance imaging (MRI), MR spectroscopy (MRS), MR diffusion-weighted imaging (DWI) and MR perfusion] were consistent with EBV encephalitis, which is a very rare complication of IM.
Case Report
A 15-month-old male patient was hospitalized in the pediatric neurology clinic with the complaints of high fever and seizure attack. In the physical examination, a single-sided continuous focal seizure attack and findings of left hemiparesis were seen. Serological investigation of the patient revealed positive EBV IgG and EBV IgM antibodies. The laboratory findings were otherwise normal, and electroencephalographic studies were unremarkable. Polymerase chain reaction (PCR) examination was not performed. No underlying disease or immunodeficiency was detected. Due to the suspicion of focal encephalitis, a brain MRI...