EPSTEIN-BARR-VIRUS GENOMIC SEQUENCES AND SPECIFIC ANTIBODIES IN CEREBROSPINAL-FLUID IN CHILDREN WITH NEUROLOGIC COMPLICATIONS OF ACUTE AND REACTIVATED EBV INFECTIONS

Four children with infectious mononucleosis (IM) and one with reactiva ted Epstein-Barr virus (EBV) infection had concomitant central nervous system disorders. Cerebrospinal fluid (CSF) samples from all five pat ients contained EBV genomic sequences and EBV-specific antibodies in t he neurologic stage, but not during convalescence. Cerebrospinal fluid from two non-neurologic IM patients had neither EBV DNA nor EBV antib odies. The EBV-positive CSF of the five with neurological disorders we re aseptic in culture and all negative for other human herpesvirus DNA s and antibodies: herpes simplex virus types 1 and 2, cytomegalovirus, varicella-zoster virus, and human herpesvirus 6. Epstein-Barr virus D NA and EBV antibodies were not detected in the CSF of 17 EBV-seroposit ive patients with mumps meningitis, rubella encephalitis, unknown febr ile convulsion, or partial epilepsy. It is suggested that EBV plays a causal role in neurologic manifestations in patients with acute and re activated EBV infections, through direct viral invasion and immunopath ological reactions. (C) 1993 Wiley-Liss, Inc.