A SYNDROME OF CONCURRENT CENTRAL AND PERIPHERAL NERVOUS-SYSTEM INVOLVEMENT DUE TO EPSTEIN-BARR-VIRUS INFECTION

Epstein-Barr virus infection can affect both the central and periphera l nervous system. In some patients this occurs concurrently. Two patie nts are presented with encephalopathy and acute quadriparesis with dim inished reflexes. Positive serology for Epstein-Barr virus was found i n both patients. Both patients had a cerebrospinal fluid pleocytosis i n the setting of progressive weakness. Electrophysiologic studies earl y in the course of their illness demonstrated abnormal F-wave latencie s with normal distal conduction. Electromyographic studies demonstrate d prominent spontaneous activity in affected limbs. As both the enceph alopathy and weakness improved, the electrophysiologic abnormalities i mproved. This presentation is characteristic of acute Epstein-Barr vir us infection. Pathologic studies in other patients have documented bot h anterior horn cell degeneration and edema as well as cellular infilt ration of nerve roots which are responsible for the paralysis with dim inished reflexes and electrophysiologic findings. The prognosis for th ese patients is generally good. (C) 1996 John Wiley & Sons, Inc.