Ataxia and Encephalitis in a Young Adult with EBV Mononucleosis : A Case Report

الملخص EN

Neurological manifestations of mononucleosis are extremely rare, occurring in about 1% of all cases.

However, when they occur, appropriate treatment must be undertaken to ensure appropriate symptomatic management and reduce morbidity.

We present the case of a 25-year-old graduate student with weeklong complaints of fever, sore throat, fatigue, nausea, and “dizziness.” She later developed increased sleep requirements, ataxia, vertigo, and nystagmus with a positive EBV IgM titer confirming acute infectious mononucleosis.

The patient was clinically diagnosed with EBV-associated cerebellitis and encephalitis, displaying neurological and psychiatric impairment commonly seen in postconcussion syndrome.

MRI showed no acute changes.

She was started on valacyclovir and a prednisone taper, recovering by the end of twelve weeks.

Though corticosteroids and acyclovir are not recommended therapy in patients presenting with EBV-associated ataxia, clinicians may want to keep a low threshold to start these medications in case more serious neurological sequelae develop.