Ataxia and Encephalitis in a Young Adult with EBV Mononucleosis: A Case Report. (28th May 2013)

• Record Type: Journal Article
• Authors: Hussain, Rashid S.; Hussain, Naaz A.
• Other Names: Berlit P. Academic Editor.; Huang C.-C. Academic Editor.; Simone I. L. Academic Editor.
• Is Part Of: Case reports in neurological medicine. Volume 2013(2013)
• Publication Date: 2013-05-28
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; Neurology; Nervous System Diseases; Nervous system -- Diseases; Neurology; Electronic journals; Periodicals; Periodicals; 616.8
• DOI: 10.1155/2013/516325
• Languages: English
• ISSNs: 2090-6676

Abstract

Abstract : Neurological manifestations of mononucleosis are extremely rare, occurring in about 1% of all cases. However, when they occur, appropriate treatment must be undertaken to ensure appropriate symptomatic management and reduce morbidity. We present the case of a 25-year-old graduate student with weeklong complaints of fever, sore throat, fatigue, nausea, and "dizziness." She later developed increased sleep requirements, ataxia, vertigo, and nystagmus with a positive EBV IgM titer confirming acute infectious mononucleosis. The patient was clinically diagnosed with EBV-associated cerebellitis and encephalitis, displaying neurological and psychiatric impairment commonly seen in postconcussion syndrome. MRI showed no acute changes. She was started on valacyclovir and a prednisone taper, recovering by the end of twelve weeks. Though corticosteroids and acyclovir are not recommended therapy in patients presenting with EBV-associated ataxia, clinicians may want to keep a low threshold to start these medications in case more serious neurological sequelae develop.