Epstein-Barr Virus Encephalitis as a Cause of Status Epilepticus – A Rare Encounter

TL;DR

This paper reports a rare case of Epstein-Barr virus encephalitis causing status epilepticus in a young woman, highlighting the need for early diagnosis.

Contribution

The paper presents a rare case of EBV encephalitis manifesting as status epilepticus in a non-immunodeficient patient.

Findings

The patient showed bilateral symmetric brain lesions and positive EBV IgG and IgM.

Treatment with ganciclovir and anti-epileptics led to gradual improvement.

The case underscores the importance of considering EBV in status epilepticus without immunodeficiency.

Abstract

Epstein-Barr virus (EBV) is associated with infectious mononucleosis and is known to cause various neurological complications, albeit rarely. EBV encephalitis is a rare manifestation, and even rarer is its presentation as status epilepticus. To date, fewer than ten cases of EBV encephalitis presenting as status epilepticus have been reported globally. We report a case of an 18-year-old girl who presented with fever followed by seizures. She went into status epilepticus the next day. Cerebrospinal fluid (CSF) analysis showed lymphocytic predominance. Brain imaging showed bilateral symmetric hyperintense lesions in the caudate and the putamen. EBV IgG and IgM were found to be positive. The patient was treated with ganciclovir and anti-epileptics and she improved gradually. Our case emphasizes the importance of considering EBV encephalitis as a potential cause of status epilepticus, even in individuals without immunodeficiency. Recognizing atypical presentations and appropriate diagnostic investigations can facilitate early diagnosis and treatment initiation.

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