Most primary EBV infections of children are asymptomatic. In adolescents and young adults, the usual syndrome associated with primary infection is infectious mononucleosis (35–75% of infections).
Potential neurologic complications of EBV infection include encephalitis, meningitis, meningoencephalitis, and cerebellitis. Seizures can complicate acute infection, and even status epilepticus has been reported, but most adult patients recover completely.99
In children, EBV encephalitis was previously considered a self-limited illness, usually with few or no sequelae. A review of pediatric EBV encephalitis or meningoencephalitis cases, however, has revealed that acute neurologic manifestations are diverse, including 36% of patients with seizures. Classic signs, symptoms, and lab findings of infectious mononucleosis were noted infrequently. Abnormal EEGs occurred in 64% in the acute setting, and of these, 43% had persistent abnormalities on follow-up. Thus, neurologic sequelae including seizures occur in a substantial number of children with EBV encephalitis.100
Reviewed and revised March 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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