ACUTE ARCUATE FIBER DEMYELINATING ENCEPHALOPATHY FOLLOWING EPSTEIN-BARR-VIRUS INFECTION

We describe a patient who presented with an acute monophasic illness c haracterized by behavioral abnormalities, visual illusions, and a seiz ure, who had magnetic resonance- and brain biopsy-documented evidence of multifocal central nervous system demyelination. Serological studie s were diagnostic of recent Epstein-Barr virus infection and included evidence of intrathecal synthesis of Epstein-Barr virus-specific IgG a ntibodies against the viral capsid antigen. Viral DNA could not be amp lified from cerebrospinal fluid by polymerase chain reaction, and vira l antigen and genome were not detected in the brain biopsy specimen. T he patient's clinical course, diagnostic studies, and neuropathologica l findings all support the diagnosis of a postinfectious Epstein-Barr virus-mediated demyelinating encephalopathy.