Transient seizure‐related MRI abnormalities in a child with primary Epstein–Barr virus infection

We describe the case of a 6‐year‐old girl with typical infectious mononucleosis syndrome complicated by clustered right hemiconvulsions and disturbed consciousness. Diffusion‐weighted magnetic resonance imaging on admission demonstrated reduced diffusion in the left temporo‐posterior cortex and pulv...

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Bibliographic Details
Published in:Pediatrics international 2016-06, Vol.58 (6), p.525-527
Main Authors: Kamakura, Tae, Hiraki, Akiyoshi, Kikuchi, Masahiro
Format: Article
Language:English
Subjects:
Cerebrospinal fluid
Convulsions & seizures
cytokine
diffusion‐weighted magnetic resonance imaging
Encephalitis
Encephalopathy
Epstein-Barr virus
Infectious mononucleosis
Magnetic resonance imaging
Mononucleosis
Neuroimaging
Neuroprotection
NMR
Nuclear magnetic resonance
Pediatrics
Pulvinar
Resonance
Seizing
status epilepticus
Thalamus
Viral infections
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Summary:We describe the case of a 6‐year‐old girl with typical infectious mononucleosis syndrome complicated by clustered right hemiconvulsions and disturbed consciousness. Diffusion‐weighted magnetic resonance imaging on admission demonstrated reduced diffusion in the left temporo‐posterior cortex and pulvinar of the ipsilateral thalamus. Her neurological symptoms resolved completely by the next day, with complete disappearance of abnormal signal intensities on magnetic resonance imaging (MRI). Elevated cerebrospinal fluid interleukin (IL)‐6 with normal IL‐10 might indicate a neuroprotective role of IL‐6 rather than injury. We concluded that the MRI abnormalities could have been due to the seizure activity itself rather than Epstein–Barr virus‐associated encephalitis. The recognition of transient seizure‐related MRI abnormalities may help in the diagnostic approach to MRI changes in suspected encephalopathy.
ISSN:1328-8067
1442-200X
DOI:10.1111/ped.12844