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Journal of Child Neurology
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Persistent Preceding Focal Neurologic Deficits in Children With Chronic Epstein-Barr Virus Encephalitis

June M. Caruso, DO

Department of Pediatric Neurology, Children's National Medical Center Washington, DC, jcaruso{at}cnmc.org

Glenn A. Tung, MD

Department of Diagnostic Imaging Hasbro Children's Hospital and Rhode Island Hospital, Brown University School of Medicine, Providence, RI

Generoso G. Gascon, MD

Department of Pediatric Neurology, Brown University School of Medicine, Providence, RI

Jeffrey Rogg, MD

Department of Diagnostic Imaging Hasbro Children's Hospital and Rhode Island Hospital, Brown University School of Medicine, Providence, RI

Lawrence Davis, MD

Department of Diagnostic Imaging Hasbro Children's Hospital and Rhode Island Hospital, Brown University School of Medicine, Providence, RI

William D. Brown, MD

Department of Pediatric Neurology, Brown University School of Medicine, Providence, RI

Epstein-Barr virus encephalitis is a self-limiting disease with few sequelae. Persistence of neurologic deficits prior to and after the acute illness has yet to be described in children. We describe five children with persistent cognitive and focal neurologic deficits due to chronic Epstein-Barr virus encephalitis with various T 2-weighted magnetic resonance imaging abnormalities. Clinical features were a 9-year-old boy with aphasia and apraxia, an 11-year-old girl with impulsivity and inappropriate behavior, a 17-year-old boy with deterioration of cognitive skills and judgment, a 5-year-old boy with complex-partial seizures, and a 6-year-old girl with obsessive-compulsive behavior. All patients had elevated serum Epstein-Barr virus titers for acute infection, with cerebrospinal fluid polymerase chain reaction positive for Epstein-Barr virus in four patients. Three children were treated with methylprednisolone with minimal improvement without changes on magnetic resonance imaging. Epstein-Barr virus encephalitis can present with chronic and insidious neurologic symptoms and should be considered in the differential diagnosis of children with acute or chronic neurologic illness of unknown etiology. (J Child Neurol 2000;15:791-796).

Journal of Child Neurology, Vol. 15, No. 12, 791-796 (2000)
DOI: 10.1177/088307380001501204
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