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.
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.
• 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.
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