Epstein-Barr virus infections of the nervous system

Catherine Amlie-Lefond MD (Dr. Amlie-Lefond of the University of Washington has no relevant financial relationships to disclose.)
Karen L Roos MD FAAN, editor. (Dr. Roos of Indiana University School of Medicine has no relevant financial relationships to disclose.)
Originally released January 27, 1999; last updated December 24, 2013; expires December 24, 2016

This article includes discussion of Epstein-Barr virus infections of the nervous system, EBV encephalitis, and EBV infection. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Epstein-Barr virus is a herpes virus associated with infectious mononucleosis. Protean neurologic presentations associated with infectious and postinfectious complications can be seen. Manifestations of neurologic disease associated with Epstein-Barr virus are reviewed in this article. Advances in diagnosis, including polymerase chain reaction for Epstein-Barr virus in CSF, are discussed. Treatment is primarily supportive.

Key points

 

• Epstein-Barr virus is a herpes virus associated with infectious mononucleosis.

 

• Protean neurologic presentations associated with infectious and postinfectious complications of Epstein-Barr virus can be seen.

 

• The role of Epstein-Barr virus infection in multiple sclerosis is an area of intense research, but a causal relationship has not been definitively demonstrated.

Historical note and terminology

Epstein-Barr virus was identified in 1964 by Epstein and colleagues (Epstein et al 1964) from a lymphoma of the jaw, which had been recognized in Central African children by Burkitt (Burkitt 1958). Several years later it was recognized that Epstein-Barr virus was the etiologic agent of heterophil-positive infectious mononucleosis (Henle et al 1968). Epstein-Barr virus belongs to the herpes virus family. In addition to being the cause of infectious mononucleosis, Epstein-Barr virus has also been associated with several neoplastic conditions including Burkitt lymphoma, nasopharyngeal carcinoma, hairy cell leukoplakia, lymphocytic lymphomas of immunosuppressed patients, and primary CNS lymphoma. X-linked lymphoproliferative syndrome is manifested by extreme sensitivity to Epstein-Barr virus, and is associated with severe or fatal mononucleosis, hypogammaglobulinemia, and lymphoma. It has been linked to a mutation in the long arm of the X chromosome (Coffey et al 1998). The following discussion will concentrate on the neurologic manifestations of Epstein-Barr virus infection.

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.