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Case Reports in Neurological Medicine
Volume 2013 (2013), Article ID 516325, 3 pages
http://dx.doi.org/10.1155/2013/516325
Case Report

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

1Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
2Johns Hopkins Community Physicians, Frederick, MD 21701, USA

Received 24 March 2013; Accepted 13 May 2013

Academic Editors: P. Berlit, C.-C. Huang, and I. L. Simone

Copyright © 2013 Rashid S. Hussain and Naaz A. Hussain. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.