Epstein-Barr virus infections of the central nervous system.
OBJECTIVE
Epstein-Barr virus (EBV), a lymphotropic herpes virus causing infectious mononucleosis (IM), also causes various central nervous system (CNS) infections. In the present study, EBV CNS infections were investigated.


METHODS
For adult inpatients in our hospital and related hospitals between 1984-2002, CNS syndromes with IM symptoms were examined, and serologic positives were assessed according to established criteria. Polymerase chain reaction (PCR) was performed for cerebrospinal fluid (CSF) from seven patients.


RESULTS
Ten patients with EBV-related CNS infections were found; their mean age was 36 years (20-79 years). The neurologic forms were as follows: acute encephalitis (4 patients), acute cerebellar ataxia (1), acute disseminated encephalomyelitis (ADEM) (2), myelitis (1), and meningitis (2). The PCR from CSF was positive in two patients with meningitis, one patient with ADEM, and one patient with encephalitis-associated chronic EVB infection. One case of encephalitis and another of relapsing ADEM were attributed to chronic EBV infection.


CONCLUSIONS
Our study identified a variety of EBV-related CNS infections. EBV CNS infections are divided into two groups: 1) CNS syndromes associated with primary EBV or reactivated infection, and 2) those associated with chronic EBV infection; it is notable that in the former, diverse CNS syndromes including ADEM can occur, whereas in the latter, chronic or recurrent CNS syndromes are produced.
Fujimoto
Hiroshi
H
First Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011.
Asaoka
Kyoko
K
Imaizumi
Toshihiro
T
Ayabe
Mitsuyoshi
M
Shoji
Hiroshi
H
Kaji
Masahide
M
D000328:Adult; D000368:Aged; D020805:Central Nervous System Viral Diseases / Q000175:diagnosis / Q000209:etiology*; D002524:Cerebellar Ataxia / Q000209:etiology; D004279:DNA, Viral / Q000134:cerebrospinal fluid / Q000235:genetics; D004660:Encephalitis / Q000209:etiology; D004679:Encephalomyelitis / Q000209:etiology; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008587:Meningitis, Viral / Q000209:etiology; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology; D012189:Retrospective Studies
D004279:DNA, Viral