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Case report
Intravenous immunoglobulins in an adult case of post-EBV cerebellitis
  1. Eleonora D'Ambrosio1,
  2. Farnaz Khalighinejad2 and
  3. Carolina Ionete2
  1. 1Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  2. 2Neurology, University of Massachusetts, Worcester, Massachusetts, USA
  1. Correspondence to Dr Carolina Ionete; carolina.ionete{at}umassmemorial.org

Abstract

Post-Epstein-Barr virus (EBV) cerebellitis is very rare complication of infectious mononucleosis and only a few adult cases are reported in literature. We present a 23-year-old patient who was admitted to the neurology service with worsening ataxia, nystagmus and dysarthria, 1 week after infectious mononucleosis. Imaging and cerebrospinal fluid studies were normal, serum studies revealed acute transaminitis and positive EBV viral capsid IgM and IgG. The patient underwent a 5-day course of intravenous immunoglobulins with rapid resolution of all his symptoms and was safely discharged home. The pathophysiology of post-EBV cerebellitis involves autoreactive antibodies, rather than a direct viral insult. Antineuronal antibodies might be the result of a mimicry between EBV proteins and neuronal antigens or they can be secreted by the EBV-transformed lymphocytes themselves. Many reports stress the benign, self-limiting nature of this syndrome; however, immunotherapy might de facto decrease the severity and duration of illness.

  • neurology
  • Brain stem/cerebellum
  • infection (neurology)
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Footnotes

  • Contributors ED'A presented the case report. Both authors, ED'A and FK contributed to the final version of the manuscript. CI supervised the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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