SHM Converge Scientific Abstract ePoster Gallery-Acute Cerebellitis Induced by Glucocorticoid Therapy in Epstein-Barr Virus

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This case report describes a rare episode of acute cerebellitis associated with Epstein-Barr virus (EBV) infection in a 20-year-old woman, highlighting that the condition can occur in adults and may be difficult to recognize. The patient initially presented to the emergency department with dysarthria, uncontrollable laughter, and disinhibition. She had signs of cerebellar dysfunction, including ataxia, dysmetria, dysdiadochokinesia, and nystagmus, along with leukocytosis and a positive monospot test indicating recent EBV infection.<br /><br />During her hospital course, her neurologic symptoms worsened, prompting brain MRI, which showed diffuse cerebellar and meningeal enhancement. Lumbar puncture revealed lymphocytic pleocytosis. Further serologic testing confirmed EBV infection with positive EBV IgM and IgG antibodies. The clinical findings supported a diagnosis of post-EBV acute cerebellitis rather than a primary psychiatric disorder.<br /><br />The patient was treated with intravenous methylprednisone and acyclovir, with only slight improvement in symptoms. The report emphasizes that post-EBV cerebellitis should be considered in patients with recent EBV infection who develop ataxia, cerebellar signs, or abnormal speech. It also underscores the importance of ruling out neurologic causes before attributing symptoms to psychiatric illness. The authors note that diagnosis requires a high index of suspicion and that MRI and cerebrospinal fluid analysis are key diagnostic tools.<br /><br />Overall, the case highlights the potential severity of EBV-associated cerebellitis in adults and the need for further research to establish a clear treatment protocol, as delayed recognition may lead to poor outcomes.

Asset Subtitle

Hiren Patel

Meta Tag

Author List Adam Loutfy, Hiren Patel, Norton Winer, Remie Saab

Category Clinical Vignettes

Distinguished Non-Finalist

Presenter Organization University Hospitals

Presenting Author Hiren Patel

Track Adult

Keywords

Epstein-Barr virus

acute cerebellitis

adult case report

ataxia

dysarthria

cerebellar dysfunction

MRI enhancement

lymphocytic pleocytosis

monospot test

intravenous methylprednisone