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 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neurologic complications in three girls, aged four, fourteen and fifteen years, with infectious mononucleosis are reported. All three patients had meningoencephalitis, in two of them cerebellar involvement predominated, while the third patient had cerebral involvement with paresis of cerebral nerves. The diagnosis of an Epstein-Barr virus infection was established serologiccally and in the first patient also by the detection of the Epstein-Barr virus.
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PMID:Central nervous system involvement in infectious mononucleosis with studies for Epstein-Barr virus. 18 53

In a 35-year-old woman who presented with acute somnolence, confusion and slow irregular breathing, Epstein-Barr virus (EBV) meningoencephalitis was diagnosed after serological testing and a polymerase chain reaction of the cerebrospinal fluid. She developed papilloedema and bilateral nervus abducens paresis. A CT scan showed generalized oedema of the brain and triventricular hydrocephalus. Treatment with a ventriculoperitoneal shunt and ganciclovir led to complete recovery. Meningoencephalitis is a not uncommon, yet rarely reported complication of infectious mononucleosis. It usually runs a mild course with spontaneous and full recovery. Hydrocephalus secondary to aqueduct stenosis is a complication of Epstein-Barr virus (EBV) meningoencephalitis which has not been reported in adults before. The disease should be considered whenever the clinical condition deteriorates or neurological symptoms increase.
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PMID:[Meningo-encephalitis and hydrocephalus caused by Epstein-Barr virus]. 962 31

Infectious mononucleosis is a common diagnosis in the pediatric and young adult population. Symptoms include low grade fever, malaise, odynophagia, and cervical lymphadenopathy. Neurological manifestations are uncommon, but include cranial nerve neuropathies. We describe a case of infectious mononucleosis in a pediatric patient who presented with a parotid mass and facial nerve palsy. Diagnosis was confirmed with a monospot test and Epstein-Barr virus antibody panel. The patient was managed conservatively with near total recovery of facial nerve function. This case demonstrates the need to consider infectious etiology prior to surgical intervention of a pediatric patient with facial nerve paresis and a parotid mass.
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PMID:Parotid mass: Epstein-Barr virus and facial paralysis. 1137 91

Acute cerebellitis is one of the main causes of acute cerebellar dysfunction in children. It is either infectious, usually viral, post-infectious or post vaccinal in etiology. Diagnosing acute cerebellitis may be difficult in patients with only subtle cerebellar signs and when cerebro-spinal fluid examination is normal. MRI is the most adequate imaging technique to demonstrate cerebellar involvement. The authors report the clinical and neuro-imaging findings in 4 paediatric cases. Patient's age varied from 2 to 7 years and predominant clinical symptoms were fever, headache and vomiting; ataxia was noted only in 2 cases. Viral serologic tests were negative in 3 cases and demonstrated Epstein-Barr virus in 1. Initial MRI examination (2 cases) demonstrated increased intensity on T2W and Flair sequences of the cerebellar gray matter with pial enhancement. Clinical outcome was good with complete resolution of symptoms in 3 cases and persistent mild right upper limb paresis in one. The resolution of the signal abnormality was well demonstrated on MRI in one case, suggesting an inflammatory etiology with moderate residual cerebellar atrophy.
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PMID:[Imaging of acute cerebellitis in children. Report of 4 cases]. 1652 4

Nasopharyngeal carcinoma (NPC) is a tumor arising from the epithelial cells that cover the surface and line the nasopharynx. The annual incidence of NPC in the UK is 0.3 per million at age 0-14 years, and 1 to 2 per million at age 15-19 years. Incidence is higher in the Chinese and Tunisian populations. Although rare, NPC accounts for about one third of childhood nasopharyngeal neoplasms. Three subtypes of NPC are recognized in the World Health Organization (WHO) classification: 1) squamous cell carcinoma, typically found in the older adult population; 2) non-keratinizing carcinoma; 3) undifferentiated carcinoma. The tumor can extend within or out of the nasopharynx to the other lateral wall and/or posterosuperiorly to the base of the skull or the palate, nasal cavity or oropharynx. It then typically metastases to cervical lymph nodes. Cervical lymphadenopathy is the initial presentation in many patients, and the diagnosis of NPC is often made by lymph node biopsy. Symptoms related to the primary tumor include trismus, pain, otitis media, nasal regurgitation due to paresis of the soft palate, hearing loss and cranial nerve palsies. Larger growths may produce nasal obstruction or bleeding and a "nasal twang". Etiological factors include Epstein-Barr virus (EBV), genetic susceptibility and consumption of food with possible carcinogens--volatile nitrosamines. The recommended treatment schedule consists of three courses of neoadjuvant chemotherapy, irradiation, and adjuvant interferon (IFN)-beta therapy.
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PMID:Nasopharyngeal carcinoma. 1680 Aug 83

A 31-year-old woman with Crohn's disease that had been refractory to drug therapies for 7 years had been treated with infliximab for a year. She was admitted to our hospital because of truncal ataxia and bulbar palsy, which presented following aseptic meningitis. Neurological examination revealed abducens paresis on the left, gaze-evoked nystagmus on upward and rightward gaze, right facial muscle weakness, bulbar palsy, weakness in the right upper extremity, limb ataxia predominantly on the left side, diminished sense in the lower extremities predominantly on the right, diffuse hyperreflexia in all extremities. Antibodies to Epstein-Barr virus (EBV) in serum demonstrated a previous infection pattern, and EBV-DNA was detected in peripheral blood and cerebrospinal fluid (CSF) by PCR. CSF analysis indicated pleocytosis, an elevation of IgG index and a marked increase in the level of myelin basic protein. FLAIR MRI images revealed multiple hyperintense lesions in the brainstem, subcortical white matter, and cervical spinal cord. Accordingly, we diagnosed her as having acute disseminated encephalomyelitis (ADEM), associated with reactivated EBV infection. Although gancyclovir, plasma exchange and intravenous high dose immunoglobulins were not effective, repetitive use of methylprednisolone pulse therapy alleviated her symptoms and the abnormal MRI lesions. It is suggested that the reactivated EBV infection caused by infliximab may have contributed to the development of ADEM in this case. Besides the demyelinating event directly induced by anti-TNF-alpha therapy, we should pay attention to the occurrence of reactivated EBV-triggered ADEM during anti-TNF-alpha therapy.
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PMID:[A case of acute disseminated encephalomyelitis associated with Epstein-Barr virus reactivation during infliximab therapy]. 2068 Dec 62