Domachowske J B, Cunningham C K, Cummings D L, Crosley C J, Hannan W P, Weiner L B
Department of Pediatrics, State University of New York, Health Science Center at Syracuse, USA.
Pediatr Infect Dis J. 1996 Oct;15(10):871-5. doi: 10.1097/00006454-199610000-00008.
Complications of Epstein-Barr virus (EBV) infection are diverse and include a number of neurologic manifestations such as meningitis, meningoencephalitis, cerebellitis, cranial neuritis and others. In general encephalitis caused by EBV in pediatric patients has been considered a self-limited illness with few or no sequelae.
Charts were reviewed from all patients < 18 years of age admitted to or discharged from the State University of New York Health Science Center at Syracuse between 1982 and 1992 with a diagnosis of encephalitis or meningo-encephalitis. Eleven cases of EBV encephalitis diagnosed during a 10-year period were reviewed to characterize the clinical and laboratory findings in the acute setting and the extent of neurologic sequelae on follow-up.
Acute neurologic manifestations were diverse and included combative behavior (55%), seizures (36%), headache (36%) and evidence of focal involvement (27%). Classic findings of infectious mononucleosis were noted infrequently; 18% each had pharyngitis, adenopathy, positive heterophile antibody tests or atypical lymphocytosis. Two patients (18%) had abnormal neuroimaging studies, one in the acute stage and the other at the time of follow-up. Seven patients (64%) had abnormal electroencephalograms (EEGs) in the acute setting; of these three had persistent abnormalities on follow-up. Forty percent developed persistent neurologic abnormalities including global impairment, perseverative autistic-like behavior and persistent left upper extremity paresis.
Classic signs, symptoms and laboratory findings in infectious mononucleosis may be absent in Epstein-Barr virus encephalitis. Neurologic sequelae occur in a substantial number of patients.
爱泼斯坦-巴尔病毒（EBV）感染的并发症多种多样，包括一些神经系统表现，如脑膜炎、脑膜脑炎、小脑炎、颅神经炎等。一般来说，小儿患者中由EBV引起的脑炎被认为是一种自限性疾病，很少或没有后遗症。
回顾了1982年至1992年间在锡拉丘兹的纽约州立大学健康科学中心入院或出院的所有18岁以下诊断为脑炎或脑膜脑炎患者的病历。对10年间诊断的11例EBV脑炎病例进行回顾，以描述急性期的临床和实验室检查结果以及随访时神经后遗症的程度。
急性神经表现多种多样，包括好斗行为（55%）、癫痫发作（36%）、头痛（36%）和局灶性受累证据（27%）。传染性单核细胞增多症的典型表现很少见；分别有18%的患者出现咽炎、淋巴结病、嗜异性抗体试验阳性或非典型淋巴细胞增多。两名患者（18%）神经影像学检查异常，一名在急性期，另一名在随访时。7名患者（64%）在急性期脑电图（EEG）异常；其中3名在随访时仍有持续异常。40%的患者出现持续性神经异常，包括全面功能障碍、持续性自闭症样行为和持续性左上肢麻痹。
传染性单核细胞增多症的典型体征、症状和实验室检查结果在EBV脑炎中可能不存在。相当多的患者会出现神经后遗症。
