Poorthuis Michiel H F, Battjes Suzanne, Dorigo-Zetsma J Wendelien, de Kruijk Jelle R
Department of Neurology, Tergooi, Blaricum, The Netherlands.
Department of Medical Microbiology, Tergooi, Blaricum, The Netherlands.
BMJ Case Rep. 2018 Aug 29;2018:bcr-2018-225333. doi: 10.1136/bcr-2018-225333.
Neurological manifestations of a primary Epstein-Barr virus (EBV) infection are rare. We describe a case with acute transverse myelitis and another case with a combination of polyradiculitis and anterior horn syndrome as manifestations of a primary EBV infection.The first case is a 50-year-old immunocompetent male diagnosed with acute transverse myelitis, 2 weeks after he was clinically diagnosed with infectious mononucleosis. The second case is an 18-year-old immunocompetent male diagnosed with a combination of polyradiculitis and anterior horn syndrome while he had infectious mononucleosis. The first patient was treated with methylprednisolone. After 1 year, he was able to stop performing clean intermittent self-catheterisation. The second patient completely recovered within 6 weeks without treatment.Primary EBV infection should be considered in immunocompetent patients presenting with acute transverse myelitis and a combination of polyradiculitis and anterior horn syndrome. Antiviral treatment and steroids are controversial, and the prognosis of neurological sequelae is largely unknown.
原发性爱泼斯坦-巴尔病毒（EBV）感染的神经学表现较为罕见。我们描述了一例急性横贯性脊髓炎病例以及另一例以多发性神经根炎和前角综合征为原发性EBV感染表现的病例。第一例是一名50岁免疫功能正常的男性，在临床诊断为传染性单核细胞增多症2周后被诊断为急性横贯性脊髓炎。第二例是一名18岁免疫功能正常的男性，在患传染性单核细胞增多症时被诊断为多发性神经根炎和前角综合征。第一名患者接受了甲泼尼龙治疗。1年后，他能够停止清洁间歇性自我导尿。第二名患者未经治疗在6周内完全康复。对于出现急性横贯性脊髓炎以及多发性神经根炎和前角综合征的免疫功能正常患者，应考虑原发性EBV感染。抗病毒治疗和类固醇治疗存在争议，神经后遗症的预后很大程度上未知。
