Rodrigo-Armenteros Patricia, Kapetanovic-García Solange, Antón-Méndez Lander, Gómez-Muga Juan José, Río Edurne Bedia-Del, Fernández-Cuesta María Ángeles, García-Moncó Juan Carlos
Departments of Neurology, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain.
Radiology, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain.
Clin Neurol Neurosurg. 2019 Oct;185:105492. doi: 10.1016/j.clineuro.2019.105492. Epub 2019 Aug 19.
Neurological complications of Epstein Barr virus (EBV) infection are infrequent and may include occasionally encephalitis, usually with a benign evolution. We here report on an aggressive case of EBV encephalitis in a 14-year-old boy with extensive basal ganglia involvement, and to a lesser degree of brain cortex who presented atypically with akinetic mutism and non-convulsive status epilepticus, requiring intensive care but showed a favorable outcome. EBV encephalitis is uncommon and its best management is unclear. Its pathophysiology is not well understood but could include autoimmunity. Onconeuronal and synaptic antibodies were negative in serum and cerebrospinal fluid, including the dopamine D2 receptor. To the best of our knowledge, this is the first report to evaluate antibodies to D2 receptors in EBV encephalitis. Corticosteroid therapy is usually recommended but the use of acyclovir is controversial. Intensive care is required in severe cases to assure a favorable outcome.
爱泼斯坦-巴尔病毒（EBV）感染的神经系统并发症并不常见，偶尔可能包括脑炎，通常病情呈良性发展。我们在此报告一例14岁男孩的侵袭性EBV脑炎病例，该病例基底节广泛受累，大脑皮质受累程度较轻，表现为运动不能性缄默症和非惊厥性癫痫持续状态，情况不典型，需要重症监护，但最终预后良好。EBV脑炎并不常见，其最佳治疗方法尚不清楚。其病理生理学尚未完全明了，但可能包括自身免疫。血清和脑脊液中的肿瘤神经元及突触抗体均为阴性，包括多巴胺D2受体抗体。据我们所知，这是首篇评估EBV脑炎中D2受体抗体的报告。通常推荐使用皮质类固醇疗法，但阿昔洛韦的使用存在争议。严重病例需要重症监护以确保良好预后。
