Epstein-Barr virus encephalitis

Infectious diseases

General description

Epstein-Barr (EB) virus infection, attributable to Herpesvirus type 4, manifests as a prevalent condition. Data indicate that approximately 50% of children by the age of five years and nearly 90% of adults have experienced an EB virus infection.

Predominantly, infections by the EB virus proceed without symptomatic manifestations. Following the primary infection phase, the EB virus establishes latency akin to other Herpesviruses, predominantly within the white blood cells. It is during this latency period that individuals intermittently excrete the virus in their saliva, facilitating the potential transmission to others despite the absence of symptomatic presentation.

Moreover, the EB virus demonstrates a capacity to infect various components of the nervous system, ranging from the central to the peripheral domains, consequently eliciting disturbances such as impaired consciousness and myelomeningitis.

Striatal encephalitis

  • Caudate nucleus
  • Putamen
Symmetric
Bilateral
T2WI
Hyperintensity
FLAIR
Hyperintensity

Epstein-Barr (EB) virus encephalitis predominantly targets the basal ganglia, with a marked preference for the striatum.

Cerebral and cerebellar involvement

  • Cerebrum
    Cerebral white matter
    Subcortical white matter
  • Cerebrum
    Insula
  • Cerebellum
Bilateral
T2WI
Hyperintensity
FLAIR
Hyperintensity

In addition to striatum, the subcortical white matter, insular cortex, cerebellum are also implicated in the pathological spectrum of the infection.

Optic nerve involvement

  • Optic nerve
    Optic chiasm
  • Optic nerve
Bilateral
Morphology
Enlargement / swelling
CE T1WI
Enhancement
STIR
Hyperintensity

Bilateral optic nerves, including the optic chiasm, can also be affected.