Brainstem encephalitis resulting from Epstein-Barr virus mimicking an infiltrating tumor in a child

A case of a child with subacute neurologic features and imaging findings co nsistent with a brainstem encephalitis that was discovered to be related to a primary central nervous system infection caused by Epstein-Barr virus is presented. A brainstem tumor was initially suspected, but a correct diagno sis was formulated on the basis of the favorable clinical course and the de tection of positive Epstein-Barr virus serology. In contrast to a prompt re covery of neurologic signs the neuroimaging alterations persisted for a lon ger time. The present report emphasizes the possible role of Epstein-Barr v irus in the pathogenesis of infectious neurologic disorders in childhood, u nderlining the unusual presentation of a brainstem encephalitis, and consid ers the discrepancy between the course of neurologic features and the evolu tion of imaging alterations. (C) 2000 by Elsevier Science Inc. All rights r eserved.