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Journal of Child Neurology
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The Neuroanatomic Localization of Epstein-Barr Virus Encephalitis May be a Predictive Factor for its Clinical Outcome: A Case Report and Review of 100 Cases in 28 Reports

Kasim Abul-Kasim, MD

Department of Radiology, Section of Neuroradiology, Malmö University Hospital, University of Lund, Sweden, Kasim.Abul-Kasim{at}med.lu.se

Lars Palm, MD, PhD

Department of Paediatrics, Malmö University Hospital, University of Lund, Sweden

Pavel Maly, MD, PhD

Department of Radiology, Section of Neuroradiology, Malmö University Hospital, University of Lund, Sweden

Pia C. Sundgren, MD, PhD

Department of Radiology, Division of Neuroradiology, University of Michigan Health Systems, Ann Arbor, Michigan

Encephalitis is one of the manifestations of infection with Epstein-Barr virus with clinical outcome varying from complete recovery to death. A 16-year-old boy with Epstein-Barr virus encephalitis with global cortical and subcortical gray matter involvement and a full clinical recovery is reported. The case inspired a literature review which yielded 100 cases of Epstein-Barr virus encephalitis subjected to radiological investigation and published in 28 reports. Cerebellum and basal ganglia were reported to be equally involved by Epstein-Barr virus infection, next to cerebral hemisphere. Patients with isolated hemispheric gray or white matter involvement were reported to achieve good recovery while almost half of the patients with thalamic involvement developed sequelae. The highest mortality rate was among patients with isolated brain stem involvement. In conclusion, neuroanatomic distribution of the radiological abnormalities in Epstein-Barr virus encephalitis may be useful as a prognostic marker.

Key Words: Epstein-Barr virus encephalitis • magnetic resonance imaging • computed tomography • gray matter involvement • cerebellitis

This version was published on June 1, 2009

Journal of Child Neurology, Vol. 24, No. 6, 720-726 (2009)
DOI: 10.1177/0883073808327842
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