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Epstein-Barr virus encephalitis in children

Gulsen Akkoc, Eda Kepenekli Kadayifci, Ayse Karaaslan, Serkan Atici, Nurhayat Yakut, Sevliya Ocal Demir, Ahmet Soysal, Mustafa Bakir
Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain...
2016: Case Reports in Infectious Diseases
Tamer Çelik, Ümit Çelik, Orkun Tolunay, Mustafa Kömür, Hüseyin Başpınar, Cengiz Yılmaz, Gülen Mert, Dinçer Yıldızdaş
Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illness common in children. Many studies described nervous system manifestations of infectious mononucleosis with a wide spectrum of neurologic deficits. Neurologic complications of EBV are seen in both acute and reactivate infection. Herein, we describe a patient diagnosed by acute EBV encephalitis with substantia nigra involvement and excellent clinical recovery.
October 2015: Journal of Pediatric Neurosciences
Katarzyna Mazur-Melewska, Iwona Breńska, Katarzyna Jończyk-Potoczna, Paweł Kemnitz, Ilona Pieczonka-Ruszkowska, Anna Mania, Wojciech Służewski, Magdalena Figlerowicz
We retrospectively analyzed the medical documentation of 194 children infected with Epstein-Barr virus. The diagnosis was based on clinical symptoms and the presence of the viral capsid antigen IgM antibody. Patients with severe neurologic complications also underwent neurologic examination, magnetic resonance imaging (MRI), and electroencephalography (EEG). There were 2 peaks in incidence of infection; the first one in young children aged 1 to 5 years represented 62.0% of cases. The second peak (24.6% of patients) occurred in teenagers...
May 2016: Journal of Child Neurology
Nili Yanai Milshtein, Gideon Paret, Shimon Reif, Ora Halutz, Galia Grisaru-Soen
OBJECTIVES: The clinical characteristics, pathogens, and outcome were analyzed to investigate the etiology of acute pediatric encephalitis in 2 tertiary pediatric medical centers in Israel. METHODS: A retrospective study among children aged 1 month to 18 years hospitalized with the diagnosis of acute encephalitis between January 1999 and December 2009. Data on presenting symptoms, clinical findings, microbiological, virologic, electroencephalographic and neuroimaging studies, laboratory results, and hospital course were retrieved from the medical records and the computerized microbiology database...
February 2016: Pediatric Emergency Care
Filippo Greco, Maria Donatella Cocuzza, Pierluigi Smilari, Giovanni Sorge, Lorenzo Pavone
Children with acute encephalopathy show prolonged electrographic seizure activity consistent with nonconvulsive status epilepticus (NCSE). Pediatric NCSE is a heterogeneous clinical entity with poor outcome and different etiologies, including central nervous system infection, stroke, toxic-metabolic syndrome, and epileptic syndrome. We report a 4-year-old girl with seizure and behavioral changes in whom the analysis of cerebrospinal fluid by polymerase chain reaction was positive for Epstein-Barr virus. We emphasize the importance of electroencephalography (EEG), and particularly, of continuous EEG monitoring for early recognition and appropriate treatment of this condition...
2014: Case Reports in Pediatrics
Aji George Mathew, Yusuf Parvez
Epstein Barr virus (EBV) encephalitis is rare in children but can have severe neurological complications and sometimes fatal. It can manifest with varied neurological presentations like meningoencephalitis, brain stem encephalitis, GBS etc. This can appear alone or with clinical picture of infectious mononucleosis. Establishing a diagnosis of EBV encephalitis is difficult and consequently molecular, serological and imaging techniques should be used when investigating a child with encephalitis. To highlight this entity we report two fatal cases of EBV meningoencephalitis presenting with sole neurological manifestations...
April 2013: Indian Pediatrics
Yaping Li, Shuangsuo Dang, Huiling Deng, Wenjun Wang, Xiaoli Jia, Ning Gao, Mei Li, Jun Wang
Severe hand, foot, and mouth disease (HFMD) is likely to develop critical complications such as brainstem encephalitis, acute pulmonary edema, and circulatory failure, which cause child mortality during outbreaks. This study aims to investigate factors that predict the severity of HFMD. One hundred sixteen in-patient children with severe HFMD and 202 with mild HFMD were retrospectively enrolled. Potential factors were collected for each child including sex, age, residence, modes of delivery, birth weight, virus types causing HFMD, and virus exposure history...
May 2013: European Journal of Pediatrics
Suneth Karunarathne, Yapa Udayakumara, Harshini Fernando
INTRODUCTION: Post-infectious cerebellitis is an acute form of inflammatory encephalitis mainly limited to the cerebellum. It is commonly found in children, especially after viral infections such as Epstein-Barr virus. Post-infectious cerebellitis presents with acute onset dysarthria and ataxia. To the best of our knowledge, this is the first case report of post-infectious cerebellitis in a patient with both dengue and Epstein-Barr viral infection confirmed on serology. CASE PRESENTATION: A 43-year-old Sri Lankan Sinhala man presented with an acute febrile illness associated with thrombocytopenia...
2012: Journal of Medical Case Reports
M Kleines, J Schiefer, A Stienen, M Blaum, K Ritter, M Häusler
The purpose of this study was to delineate the spectrum of neurological diseases attributed to Epstein-Barr virus (EBV) activity. The approach was a retrospective study on patients with EBV activity proven by a positive EBV antibody-specific index (AI) and/or cerebrospinal fluid (CSF) PCR. One hundred six children and adults (AI positive = 77, AI + PCR positive = 3, PCR positive = 26) were identified, most with reactivated infections. Twenty-eight showed typical EBV-related diseases (encephalitis, neuritis, meningitis), 19 further infections (HSV encephalitis, neuroborreliosis, HIV infection, bacterial meningitis), nine immune-mediated disorders (multiple sclerosis, optic neuritis), and 50 further diseases not typical for EBV...
December 2011: European Journal of Clinical Microbiology & Infectious Diseases
P Piessens, F Indesteege, P Lemkens
The Alice in Wonderland syndrome is a rare clinical feature characterised by perceptual disturbances including visual disturbances and distortion of the body image. This uncommon--but often easy to recognise--syndrome, to which children seem particularly susceptible, can be defined in patients with Epstein Barr Virus (EBV) infection. This report describes a 10-year-old child with a mild upper airway obstruction and manifestations of the Alice in Wonderland syndrome resulting from an acute EBV infection. Because meningo-encephalitis was considered in the differential diagnosis, an MRI examination was performed under midazolam sedation, leading to a severe life-threatening upper airway obstruction...
2011: B-ENT
D Dodig, M Ngo, D Bailey, V Bril
Acute Epstein-Barr virus (EBV) infection is associated with central and peripheral neurological complications such as meningitis, encephalitis, myelitis and radiculopathy in 0.5-7.5% of patients. The peripheral nervous system manifestations of acute EBV infection include mononeuropathy, mononeuritis multiplex, autonomic neuropathy, and polyradiculopathy. Brachial plexopathy in children and immunocompromised adults with acute EBV infection has been described, likely as a dysimmune neuropathy triggered by the EBV...
October 2010: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
P H Lalive, M G Häusler, H Maurey, Y Mikaeloff, M Tardieu, H Wiendl, M Schroeter, H P Hartung, B C Kieseier, T Menge
BACKGROUND: Myelin oligodendrocyte glycoprotein (MOG) may be implicated in the immunopathogenesis of multiple sclerosis (MS) inducing demyelination in the animal model of MS. In adults reported anti-MOG antibody frequencies have been variable across a number of studies and can also be detected in controls. OBJECTIVE: To measure antibodies against MOG in paediatric patients with demyelinating disorders of the central nervous system and in controls. METHODS: Serum antibodies against MOG and myelin basic protein were measured by ELISA, flow cytometry (FACS) and in the liquid phase in 11 children with acute disseminated encephalomyelitis (ADEM), 22 children with MS, seven children with acute viral encephalitis and 13 healthy controls...
March 2011: Multiple Sclerosis: Clinical and Laboratory Research
R C Selter, F Brilot, V Grummel, V Kraus, S Cepok, R C Dale, B Hemmer
BACKGROUND: Epstein-Barr virus (EBV) has been discussed as a possible causative agent in inflammatory demyelinating diseases of the CNS. Cross-reactivity between EBV and myelin proteins has been proposed as a potential mechanism by which EBV could elicit an autoimmune response targeting the CNS. Recently, high antibody titers to native myelin oligodendrocyte glycoprotein (nMOG) were found in children affected by the first inflammatory demyelinating event. The relation between antibody responses to EBV and nMOG has not been addressed in children so far...
May 25, 2010: Neurology
Mei-Ting Cai, Yi-Dong Wu, Xiu-Jing Wu, Shi-Qiang Shang
OBJECTIVE: Human herpesvirus 6 (HHV-6) isolates are classified into two variants, HHV-6A and HHV-6B, based on distinct genetic, antigenic and biological characteristics. HHV-6 has been associated with encephalitis in children recently. This study aimed to establish a real time PCR assay for simultaneous detection of the two subtypes of HHV-6, and apply this new assay to children with suspected encephalitis, then analyze the relationship between the infection with HHV-6 and encephalitis in children...
July 2009: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Jianrong Shi, Yidong Wu, Meiting Cai, Shiqiang Shang
The aim of the study was to evaluate retrospectively the usefulness of polymerase chain reaction (PCR)-microarray technology, which can simultaneously detect seven human herpes viruses for rapid and accurate diagnosis of herpetic encephalitis in children. We simultaneously amplified herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2); varicella-zoster virus; Epstein-Barr virus (EBV); cytomegalovirus (CMV); and human herpes virus 6 (HHV-6A and HHV-6B) by multiplex PCR, and genotyped by DNA microarray technology...
April 2010: European Journal of Pediatrics
Masafumi Sanefuji, Shouichi Ohga, Ryutaro Kira, Akihiko Nomura, Hiroyuki Torisu, Hidetoshi Takada, Koichi Kusuhara, Toshiro Hara
Neurologic complications, including meningoencephalitis, transverse myelitis, and peripheral neuropathy, have been reported in patients with acute infectious mononucleosis. Chronic active Epstein-Barr virus and human immunodeficiency virus infections occasionally induce central nervous system lymphoma. On the other hand, central nervous system disease alone associated with Epstein-Barr virus rarely occurs in previously healthy individuals. A 15-year-old girl who developed acute disseminated encephalomyelitis-like disease presenting fever, anuresis, diplopia, and muscle weakness is described here...
September 2008: Journal of Child Neurology
C Domenech, N Leveque, B Lina, F Najioullah, D Floret
A retrospective study investigating all the infectious encephalitis cases hospitalized at the pediatric intensive care unit of Edouard Herriot University Hospital in Lyon, France, was carried out in order to estimate the prevalence of Mycoplasma pneumoniae in acute childhood encephalitis. From January 2001 to December 2005, the cases of 29 children were selected and reviewed. M. pneumoniae related encephalitis was considered as probable in five cases (17%) on the basis of positive serological tests or positive polymerase chain reaction (PCR) tests in throat or nasopharyngeal swab while the PCR tests performed from the cerebrospinal fluid were negative...
January 2009: European Journal of Clinical Microbiology & Infectious Diseases
Eugênio Grillo, Ronaldo J M da Silva, Jorge H Barbato Filho
The association of acute myelopathy and encephalopathy is reported in a 13-year-old boy. Signs and symptoms of infectious mononucleosis, presence of heterophile antibodies, anticapsid antibodies and Epstein-Barr virus DNA detected in cerebrospinal fluid, disclosed a primary or reactivated infection by Epstein-Barr virus. Outcome was rapid and benign with complete clinical recovery in 1 month, after pulse therapy with methylprednisolone. Epstein-Barr virus is a known agent related to acute disseminated encephalomyelitis, by immune mediated mechanisms...
September 2008: European Journal of Paediatric Neurology: EJPN
Henry J Baskin, Gary Hedlund
Six members of the herpesvirus family cause well-described neurologic disease in children: herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2), varicella-zoster (VZV), Epstein-Barr (EBV), cytomegalovirus (CMV), and human herpes virus-6 (HHV-6). When herpesviruses infect the central nervous system (CNS), the clinical presentation is non-specific and often confounding. The clinical urgency is often underscored by progressive neurologic deficits, seizures, or even death, and prompt diagnosis and treatment rely heavily on neuroimaging...
October 2007: Pediatric Radiology
Leon A Adams, Bastiaan Deboer, Gary Jeffrey, Richard Marley, George Garas
Epstein-Barr virus (EBV) is part of the herpesvirus family that infects up to 90% of the population. Initial infection is often subclincal in children but will generally result in symptomatic infectious mononucleosis in adolescents and adults. Ganciclovir has been utilized in immunocompromised patients with EBV encephalitis and post-liver transplant for EBV fulminant hepatitis. Herein, the successful use of ganciclovir in two immunocompetent patients with severe EBV hepatitis is reported.
November 2006: Journal of Gastroenterology and Hepatology
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