Department of Neurology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yu Zhong District, Chongqing, 400014, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
BMC Infect Dis. 2020 Nov 25;20(1):886. doi: 10.1186/s12879-020-05623-1.
To investigate the clinical characteristics of Epstein-Barr virus (EBV) infection in the pediatric nervous system (NS).
We retrospectively analyzed the clinical data and follow-up results of 89 children with neurological damage caused by EBV who were hospitalized in the children's hospital of Chongqing Medical University from January 2008 to April 2019.
EBV infection of the NS can occur at any time of the year. The highest incidence was seen in the age group of 0-4 years. Fever is the main clinical feature (74/89, 83.1%). The main clinical types were encephalitis/meningoencephalitis (64/89, 71.9%), acute myelitis (2/89, 2.2%), acute disseminated encephalomyelitis (ADEM) (3/89, 3.4%), Guillain-Barré Syndrome (GBS) (15/89, 16.9%), neurological damage caused by EBV-hemophagocytic lymphohistiocytosis (EBV-HLH) (4/89, 4.5%), and NS-post-transplant lymphoproliferative disorder (NS-PTLD) (1/89, 1.1%). Anti-N-methyl-D-aspartate receptor encephalitis was found during the convalescence of EBV encephalitis. EBV encephalitis/meningitis showed no symptoms of tonsillitis, lymph node enlargement, skin rash, hepatosplenomegaly. Acute motor axonal neuropathy is the chief complication in GBS caused by EBV.
There were significant differences in neurological complications caused by EBV. The prognosis of EBV infection in the NS is generally good. These illnesses are often self-limiting. A few cases may show residual sequelae.
探讨儿童神经系统（NS）中 EBV 感染的临床特点。
我们回顾性分析了 2008 年 1 月至 2019 年 4 月重庆医科大学儿童医院收治的 89 例因 EBV 引起神经损伤的住院患儿的临床资料及随访结果。
NS 中 EBV 感染可发生在一年中的任何时间。发病率最高的年龄组为 0-4 岁。发热是主要的临床特征（74/89，83.1%）。主要的临床类型为脑炎/脑膜炎（64/89，71.9%）、急性脊髓炎（2/89，2.2%）、急性播散性脑脊髓炎（ADEM）（3/89，3.4%）、吉兰-巴雷综合征（GBS）（15/89，16.9%）、EBV-噬血细胞性淋巴组织细胞增生症（EBV-HLH）所致的神经损伤（4/89，4.5%）和 NS 移植后淋巴组织增生性疾病（NS-PTLD）（1/89，1.1%）。在 EBV 脑炎恢复期发现抗 N-甲基-D-天冬氨酸受体脑炎。EBV 脑炎/脑膜炎无扁桃体炎、淋巴结肿大、皮疹、肝脾肿大等症状。急性运动轴索性神经病是 EBV 引起的 GBS 的主要并发症。
EBV 引起的神经系统并发症存在显著差异。NS 中 EBV 感染的预后一般较好。这些疾病通常是自限性的。少数病例可能会遗留后遗症。
