title: Transient widespread cortical and splenial lesions in acute encephalitis/encephalopathy associated with primary Epstein-Barr virus infection.
abstract: Infection with Epstein-Barr virus (EBV) is very common and usually occurs in childhood or early adulthood. Encephalitis/encephalopathy is an uncommon but serious neurological complication of EBV. A case of EBV-associated encephalitis/encephalopathy with involvement of reversible widespread cortical and splenial lesions is presented herein. An 8-year-old Chinese girl who presented with fever and headache, followed by seizures and drowsiness, was admitted to the hospital. Magnetic resonance imaging revealed high signal intensities on diffusion-weighted imaging in widespread cortical and splenial lesions. The clinical and laboratory examination results together with the unusual radiology findings suggested acute encephalitis/encephalopathy due to primary EBV infection. After methylprednisolone pulse therapy together with ganciclovir, the patient made a full recovery without any brain lesions. The hallmark clinical-radiological features of this patient included severe encephalitis/encephalopathy at onset, the prompt and complete recovery, and rapidly reversible widespread involvement of the cortex and splenium. Patients with EBV encephalitis/encephalopathy who have multiple lesions, even with the widespread involvement of cortex and splenium of the corpus callosum, may have a favorable outcome with complete disappearance of all brain lesions.
authors.affiliation: Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China. Electronic address: snow78@yeah.net.
authors.forename: Juan
authors.initials: J
authors.lastname: Feng
authors.affiliation: Department of Pediatrics, Shenyang Children's Hospital, Shenyang, Liaoning, China.
authors.forename: Yifang
authors.initials: Y
authors.lastname: Shi
mesh_terms: D001927:Brain Diseases / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D003337:Corpus Callosum / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D004660:Encephalitis / Q000473:pathology*; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans
keywords: Acute disseminated encephalomyelitis; Encephalopathy; Epstein–Barr virus encephalitis; Magnetic resonance imaging; Reversible splenial lesion