Epstein-Barr virus infections of the nervous system

Jennifer Siriwardane MD (Dr. Siriwardane of Indiana University School of Medicine has no relevant financial relationships to disclose.)
Karen L Roos MD FAAN (Dr. Roos of Indiana University School of Medicine has no relevant financial relationships to disclose.)
Originally released January 27, 1999; last updated November 27, 2017; expires November 27, 2020

This article includes discussion of Epstein-Barr virus infections of the nervous system, EBV encephalitis, EBV infection, infectious mononucleosis, and subacute sclerosing panencephalitis (SSPE). The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Epstein-Barr virus is a ubiquitous herpes virus associated with infectious mononucleosis. Neurologic complications due to acute Epstein-Barr virus infection include acute encephalitis, cerebellar ataxia, cranial nerve palsies, and Guillain-Barré syndrome.

Key points

 

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

 

• Neurologic symptoms can be seen with infectious and postinfectious complications of Epstein-Barr virus.

 

• 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

Discovered in 1964 from lymphoma cells of the jaw, Epstein-Barr virus has since been implicated in a variety of disease processes, both benign and malignant (Epstein et al 1964). The virus was discovered by Anthony Epstein, Yvonne Barr, and colleagues upon studying lymphoma from the jaw of central African children, which was found by surgeon Denis Burkitt (Burkitt 1958). Epstein and colleagues discovered the first virus that could cause cancer. Years later, Epstein-Barr virus was found to be the culprit of infectious mononucleosis, also known as glandular fever (Henle et al 1968). The virus belongs to the herpesviridae family, and the origin of the word herpes comes from the Latin word herpein, which means literally “to creep, move slowly”. It is 1 of the most common viruses among humans. It is implicated in a variety of diseases such as nasopharyngeal carcinoma, hairy cell leukoplakia, Burkitt lymphoma, lymphomas in the immunocompromised, and primary CNS lymphomas. The following discussion will concentrate on neurologic manifestations of Epstein-Barr virus.

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