Journal
MOVEMENT DISORDERS
Volume 21, Issue 4, Pages 564-566Publisher
WILEY-LISS
DOI: 10.1002/mds.20742
Keywords
acute; disseminated; encephalitis; Epstein-Barr virus; lethargica; parkinsonism
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A 10-year-old boy presented with fever, headache, vomiting, and hypersomnolence. An akinetic-rigid syndrome with tremor, dysphagia, dysphonia, and sialorrhea, as well as pyramidal signs, developed. Slightly elevated protein content was found in the cerebrospinal fluid and serological investigations were suggestive of a primary Epstein-Barr virus infection. Magnetic resonance imaging (MRI) showed massive bilateral hyperintense striatal and punctiform periventricular lesions. After 2-month treatment with steroids and antiparkinsonian drugs, all features resolved without sequelae. Control MRI demonstrated only minimal residual lesions in both putamina. Strongly resembling the encephalitis lethargica-like syndrome, this case Is an unusual presentation of parainfectious acute disseminated encephalitis. (C) 2005 Movement Disorder Society.
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