Acute Epstein–Barr Virus Infectious Partial Myelitis

Despite the MRI study, the clinical findings and the result of the cerebrospinal fluid (CSF) examination were consistent with a presumptive diagnosis of either parainfectious or infectious myelitis, with a presumed lesion involving the anterior aspect of the lower thoracic spinal cord, affecting the...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2023-05, Vol.50 (3), p.475-476
Main Authors: Désilets, Audrey, Émond, Yannick, Levy, Ariel
Format: Article
Language:English
Subjects:
Abdomen
Antigens
Cytomegalovirus
Epstein-Barr virus
Epstein-Barr Virus Infections - complications
Herpesvirus 4, Human
Humans
Immunocompetence
Immunoglobulins
Inflammation
Inflammatory diseases
Letter to the Editor: New Observation
Magnetic resonance imaging
Mononucleosis
Myelitis, Transverse
Neurological disorders
Pain
Patients
Spinal cord
Steroids
Tomography
West Nile virus
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Summary:Despite the MRI study, the clinical findings and the result of the cerebrospinal fluid (CSF) examination were consistent with a presumptive diagnosis of either parainfectious or infectious myelitis, with a presumed lesion involving the anterior aspect of the lower thoracic spinal cord, affecting the decussation of sensory fibers en route to the spinothalamic tracts at the level of the lesion, explaining the bilateral suspended sensory loss of light touch, pain, and temperature. [...]an EBV-polymerase chain reaction performed on the CSF was positive with more than 700 copies/mL and negative for CMV, varicella zoster virus, HSV, and enterovirus. Since there were only sensory symptoms, the decision was made not to start a specific treatment. 5 In fact, data show that the involved segment of the cord is swollen in half of the cases and gadolinium enhancement would be present in 37–74% of cases.6 EBV can be the cause of a number of neurological disorders including mono- and polyneuropathies, anterior horn syndrome, cranial nerve palsies, meningitis, encephalitis, and myelitis,7 which is the rarest neurological complication of EBV and happens more frequently in children than in adults.4 Stigmata of infectious mononucleosis such as fever, lymphadenopathy, or splenomegaly may or may not be present.4 EBV-deoxyribonucleic acid was detected in our patient’s CSF, supporting the etiological role of the virus in her neurological symptoms.
ISSN:0317-1671
2057-0155
DOI:10.1017/cjn.2022.58