EPSTEIN-BARR CLINICAL CASE VIRAL ENCEPHALITIS
Keywords:
viral necrotic encephalitis, Epstein-Barr virus, children.Abstract
Relevance. Epstein-Barr virus (EBV) usually causes mild, asymptomatic and self-curable infections in children and adults; however, it can sometimes lead to severe conditions such as neurological diseases, malignant diseases, liver failure and myocarditis. Neurological disorders associated with Epstein-Barr virus include meningitis, encephalitis and peripheral neuritis.
The purpose of this study is to present a rare viral lesion of the nervous system in a child, meningoencephalitis caused by EBV.
Material and methods. Clinical neurological examination, neuroimaging (MRI of the brain), virological examination by immuno-enzyme analysis.
Results. Description of the case of a girl with EBV encephalitis who had prolonged vomiting and weakness. Cranial magnetic resonance imaging showed extensive postencephalotic predominantly cystic-necrotic foci in the temporal lobe at the pole of the right hemisphere as well as in the deep gray matter of both frontal lobes.
The diagnosis was made by detecting EBV DNA in blood and saliva samples, combined with a typical neuroimaging pattern.
Discussion. Taking into account the clinical polymorphism of encephalitis, when examining patients with "idiopathic" encephalitis, a wide range of anti-neuronal autoantibodies should be studied, which will allow for early diagnosis of this pathology and adequate immunosuppressive therapy. However, a typical MRI picture with damage mainly to the cortical and subcortical parts of the frontal and temporal lobes of one or both hemispheres (not symmetrical primary encephalitic foci), with clinical cortical focal symptoms or focal seizures, requires first of all the exclusion of herpetic necrotic encephalitis.
Conclusion. The present observation has shown that the typical picture of necrotic cortical encephalitis can be characteristic not only for herpes virus type 1, but also for EBV encephalitis in immunocompetent individuals. Although in the literature, EBV in older children and adults is described as more characteristic of HIV-infected people.
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