title: Acute reversible parkinsonism in Epstein-Barr virus-related encephalitis lethargica-like illness.
abstract: A 10-year-old boy presented with fever, headache, vomiting, and hypersomnolence. An akinetic-rigid syndrome with tremor, dysphagia, dysphonia, and sialorrhea, as well as pyramidal signs, developed. Slightly elevated protein content was found in the cerebrospinal fluid and serological investigations were suggestive of a primary Epstein-Barr virus infection. Magnetic resonance imaging (MRI) showed massive bilateral hyperintense striatal and punctiform periventricular lesions. After 2-month treatment with steroids and antiparkinsonian drugs, all features resolved without sequelae. Control MRI demonstrated only minimal residual lesions in both putamina. Strongly resembling the encephalitis lethargica-like syndrome, this case is an unusual presentation of parainfectious acute disseminated encephalitis.
authors.affiliation: Clinic of Child Neurology, St. Naum University Hospital of Neurology and Psychiatry, Sofia, Bulgaria. pdimova@cablebg.net
authors.forename: Petia S
authors.initials: PS
authors.lastname: Dimova
authors.forename: Veneta
authors.initials: V
authors.lastname: Bojinova
authors.forename: Dimitar
authors.initials: D
authors.lastname: Georgiev
authors.forename: Ivan
authors.initials: I
authors.lastname: Milanov
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D002552:Cerebral Ventricles / Q000187:drug effects / Q000473:pathology / Q000821:virology; D002648:Child; D003342:Corpus Striatum / Q000187:drug effects / Q000473:pathology / Q000821:virology; D018792:Encephalitis, Viral / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000821:virology*; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000978:Antiparkinson Agents; D013256:Steroids