title: [Successful treatment of Epstein-Barr virus-related encephalomyelitis with steroid and ganciclovir].
abstract: We report a 56-year-old man with encephalomyelitis due to Epstein-Barr virus (EBV). The patient suffered from fever and headache, and become somnolent on day 10. On day 18, following treatment with an antibiotic and aciclovir, a cerebrospinal fluid (CSF) examination revealed increased protein levels and lymphocytic pleocytosis. On day 25, he developed progressive tetraplegia, hypesthesia of Th l0 dermatomes, difficulty in defecating, and urinary retention. Magnetic resonance (MR) T2-weighted images showed a high-signal lesion in the center of the medulla oblongata, patchy high-signal lesions throughout the spinal cord, and swelling of the cervical spinal cord. A polymerase chain reaction test for EBV DNA in the CSF was positive. After treatment with high-dose methyl-predonisolone, the neurological symptoms improved rapidly and the high-signal lesions in the spinal cord improved. EBV DNA in the CSF was not detected after treatment with ganciclovir. This case suggests that steroid and ganciclovir are effective for the treatment of EBV-related encephalomyelitis.
authors: Department of Neurology, Graduate School of Medical Sciences, Kumamoto University.
authors: Hirotake
authors: H
authors: Hino
authors: Masashi
authors: M
authors: Kamikawa
authors: Teruyuki
authors: T
authors: Hirano
authors: Makoto
authors: M
authors: Uchino
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004679:Encephalomyelitis / Q000188:drug therapy* / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy*; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D001562:Benzimidazoles; C483319:methylproamine; D011239:Prednisolone; D015774:Ganciclovir