Farooq Khan Ayisha, Arshad Tooba, Abdy Faryal, Wasay Mohammad
Section of Neurology, Department of Medicine, Aga Khan University, National Stadium Road, Karachi, Pakistan.
Arch Iran Med. 2025 Jan 1;28(1):67-70. doi: 10.34172/aim.28844.
Epstein-Barr virus (EBV) is associated with infectious mononucleosis and is known to cause various neurological complications, albeit rarely. EBV encephalitis is a rare manifestation, and even rarer is its presentation as status epilepticus. To date, fewer than ten cases of EBV encephalitis presenting as status epilepticus have been reported globally. We report a case of an 18-year-old girl who presented with fever followed by seizures. She went into status epilepticus the next day. Cerebrospinal fluid (CSF) analysis showed lymphocytic predominance. Brain imaging showed bilateral symmetric hyperintense lesions in the caudate and the putamen. EBV IgG and IgM were found to be positive. The patient was treated with ganciclovir and anti-epileptics and she improved gradually. Our case emphasizes the importance of considering EBV encephalitis as a potential cause of status epilepticus, even in individuals without immunodeficiency. Recognizing atypical presentations and appropriate diagnostic investigations can facilitate early diagnosis and treatment initiation.
爱泼斯坦-巴尔病毒（EBV）与传染性单核细胞增多症有关，并且已知会引起各种神经并发症，尽管很少见。EBV脑炎是一种罕见的表现，而其表现为癫痫持续状态则更为罕见。迄今为止，全球报道的以癫痫持续状态为表现的EBV脑炎病例少于10例。我们报告一例18岁女孩，她先是发热，随后出现癫痫发作。第二天她进入癫痫持续状态。脑脊液（CSF）分析显示淋巴细胞占优势。脑部影像学显示尾状核和壳核有双侧对称的高信号病变。发现EBV IgG和IgM呈阳性。患者接受了更昔洛韦和抗癫痫药物治疗，病情逐渐好转。我们的病例强调了即使在无免疫缺陷的个体中，也应将EBV脑炎视为癫痫持续状态的潜在病因的重要性。认识到非典型表现并进行适当的诊断检查有助于早期诊断和开始治疗。
