Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature

Primary Epstein-Barr virus (EBV) infection is the main cause of infectious mononucleosis (IM), which typically presents with a triad of fever, lymphadenopathy, and tonsillar pharyngitis in young adults. In contrast, neurological manifestations of IM are rare. We report on a 23-year-old man with suba...

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Autores principales:	Leon Amadeus Steiner, Aslihan Erbay, Florence Pache, Moritz Niederschweiberer, Eberhard Siebert, Karen Gertz, Klemens Ruprecht
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	oculomotor nerve palsy epstein-barr virus infectious mononucleosis magnetic resonance imaging pcr Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/7f80c5bd0a8f43d88dea02a9737b87f3
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spelling	oai:doaj.org-article:7f80c5bd0a8f43d88dea02a9737b87f32021-12-02T12:40:22ZOculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature1662-680X10.1159/000520437https://doaj.org/article/7f80c5bd0a8f43d88dea02a9737b87f32021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/520437https://doaj.org/toc/1662-680XPrimary Epstein-Barr virus (EBV) infection is the main cause of infectious mononucleosis (IM), which typically presents with a triad of fever, lymphadenopathy, and tonsillar pharyngitis in young adults. In contrast, neurological manifestations of IM are rare. We report on a 23-year-old man with subacute oculomotor nerve palsy followed by symptoms of IM 6 days later. Primary EBV infection was confirmed by PCR detection of EBV DNA in blood as well as by subsequent serology. High-resolution magnetic resonance imaging revealed an edematous change at the root exit zone and gadolinium enhancement of the right oculomotor nerve as well as pial enhancement adjacent to the right ventral mesencephalon. A review of the literature identified 5 further patients with isolated oculomotor nerve palsy as the presenting symptom of unfolding primary EBV infection. MRIs performed in 3 of those 5 patients revealed a pattern of contrast enhancement similar to that of the present case. This case report and literature review highlight that, although rare, IM should be considered in the differential diagnosis of oculomotor nerve palsy in young adults.Leon Amadeus SteinerAslihan ErbayFlorence PacheMoritz NiederschweibererEberhard SiebertKaren GertzKlemens RuprechtKarger Publishersarticleoculomotor nerve palsyepstein-barr virusinfectious mononucleosismagnetic resonance imagingpcrNeurology. Diseases of the nervous systemRC346-429ENCase Reports in Neurology, Vol 13, Iss 3, Pp 756-762 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	oculomotor nerve palsy epstein-barr virus infectious mononucleosis magnetic resonance imaging pcr Neurology. Diseases of the nervous system RC346-429
spellingShingle	oculomotor nerve palsy epstein-barr virus infectious mononucleosis magnetic resonance imaging pcr Neurology. Diseases of the nervous system RC346-429 Leon Amadeus Steiner Aslihan Erbay Florence Pache Moritz Niederschweiberer Eberhard Siebert Karen Gertz Klemens Ruprecht Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
description	Primary Epstein-Barr virus (EBV) infection is the main cause of infectious mononucleosis (IM), which typically presents with a triad of fever, lymphadenopathy, and tonsillar pharyngitis in young adults. In contrast, neurological manifestations of IM are rare. We report on a 23-year-old man with subacute oculomotor nerve palsy followed by symptoms of IM 6 days later. Primary EBV infection was confirmed by PCR detection of EBV DNA in blood as well as by subsequent serology. High-resolution magnetic resonance imaging revealed an edematous change at the root exit zone and gadolinium enhancement of the right oculomotor nerve as well as pial enhancement adjacent to the right ventral mesencephalon. A review of the literature identified 5 further patients with isolated oculomotor nerve palsy as the presenting symptom of unfolding primary EBV infection. MRIs performed in 3 of those 5 patients revealed a pattern of contrast enhancement similar to that of the present case. This case report and literature review highlight that, although rare, IM should be considered in the differential diagnosis of oculomotor nerve palsy in young adults.
format	article
author	Leon Amadeus Steiner Aslihan Erbay Florence Pache Moritz Niederschweiberer Eberhard Siebert Karen Gertz Klemens Ruprecht
author_facet	Leon Amadeus Steiner Aslihan Erbay Florence Pache Moritz Niederschweiberer Eberhard Siebert Karen Gertz Klemens Ruprecht
author_sort	Leon Amadeus Steiner
title	Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
title_short	Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
title_full	Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
title_fullStr	Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
title_full_unstemmed	Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
title_sort	oculomotor nerve palsy as a presenting symptom of epstein-barr virus-associated infectious mononucleosis: case report and review of the literature
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/7f80c5bd0a8f43d88dea02a9737b87f3
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Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature

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