[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-446463-105":59,"doc-detail-446463-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","bilateral-thalamic-encephalitis-due-to-epsteinbarr-virus-in-an-elderly-patient-a-case-report-and-literature-review","Bilateral thalamic encephalitis due to Epstein–Barr virus in an elderly patient - a case report and literature review","","Bilateral thalamic encephalitis due to Epstein–Barr virus (EBV) is a rare, severe presentation that can cause rapid neurological deterioration. The report describes an 82-year-old man with fever and acute impairment progressing to coma. CSF showed mild lymphocytic pleocytosis, elevated protein, and normal glucose; EBV-DNA was detected by PCR and anti-EBV IgM was positive. MRI revealed bilateral thalamic T2/FLAIR hyperintensities with diffusion restriction and no contrast enhancement, while autoimmune and paraneoplastic tests were negative. Despite antiviral and corticosteroid therapy, the outcome was poor.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/bilateral-thalamic-encephalitis-due-to-epsteinbarr-virus-in-an-elderly-patient-a-case-report-and-literature-review/446463/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/bilateral-thalamic-encephalitis-due-to-epsteinbarr-virus-in-an-elderly-patient-a-case-report-and-literature-review/446463.png","ImageObject",300,407,{"name":92,"@type":93},"Stanley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the patient’s age and presenting condition in this case report?","Question",{"text":112,"@type":113},"An 82-year-old man presented with high fever, confusion, and reduced responsiveness that progressed over 24 hours.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was EBV infection confirmed, and what did the CSF show?",{"text":117,"@type":113},"EBV-DNA was detected in cerebrospinal fluid by PCR, anti-EBV IgM antibodies were positive by serology, and CSF showed mild lymphocytic pleocytosis with elevated protein and normal glucose.",{"name":119,"@type":110,"acceptedAnswer":120},"What key MRI findings supported the diagnosis of bilateral thalamic encephalitis?",{"text":121,"@type":113},"MRI demonstrated bilateral thalamic hyperintensities on T2-weighted and FLAIR sequences, with restricted diffusion on DWI and corresponding hypointensity on ADC maps, without contrast enhancement.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446463,1791102157,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Perrotta etal. BMC Neurology (2026) 26:8 [https://doi.org/10.1186/s12883-025-04563-0](https://doi.org/10.1186/s12883-025-04563-0)  \nBMC Neurology  \nCASE REPORT Open Access  \nBilateral thalamic encephalitis due to Epstein– Barr virus in an elderly patient: a case report and literature review  \nFrancesco Perrotta 1*, Federica Vitale2, Ludovica De Marco 1, Andrea Sparascio 1, Pierluigi Morciano 1, Francesca De Salvo 1, Gaetano Iosa 1, Daniela Rizzo 1, Donato Piscopiello 1 and Daniele Gemma 1  \nAbstract  \nBilateral thalamic encephalitis due to Epstein–Barr virus (EBV) is a rare and severe manifestation of EBV infection, often leading to rapid neurological deterioration and poor outcomes. We report the case of an 82-year-old man with a history of arterial hypertension and a previous herpes zoster infection who presented to the emergency department with high fever and acute neurological impairment evolving into coma (Glasgow Coma Scale, GCS 3) . Cerebrospinal fluid (CSF) analysis revealed mild lymphocytic pleocytosis, elevated protein and normal glucose. EBVDNA was detected by polymerase chain reaction (PCR) and serology confirmed positive anti-EBV IgM antibodies. Autoimmune and paraneoplastic panels, including anti-NMDA receptor, anti-GQ1b, anti-MOG, anti-AQP4 and antiLGI1 antibodies, were negative. Magnetic resonance imaging (MRI) demonstrated bilateral thalamic hyperintensities on T2-weighted and FLAIR sequences, with restricted diffusion on DWI and corresponding hypointensity on ADC maps, without contrast enhancement. Angiography showed normal patency of the main intracranial vessels. Differential diagnoses such as autoimmune encephalitis, acute disseminated encephalomyelitis, Bickerstaff’s brainstem encephalitis, vascular, metabolic and other viral causes were excluded. Despite prompt antiviral and corticosteroid therapy and intensive supportive management, the clinical outcome was poor. A comprehensive literature review was performed, highlighting key clinical and radiological findings from previously published cases of EBV-related bilateral thalamic encephalitis, to improve recognition and understanding of this rare and devastating condition.  \nKeywords Epstein–Barr virus, Encephalitis, Thalamus, Diffusion-weighted imaging, ADC, Elderly, Case report  \n*Correspondence: Francesco Perrotta [francperr72@yahoo.it](francperr72@yahoo.it)  \n1Department of Anesthesia and Intensive Care, Azienda Ospedaliera“Cardinale G. Panico”, Tricase (LE), Italy  \n2Department of Anesthesiology and Intensive Care, Università Campus Bio-Medico Di Roma, Rome, Italy  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/.  \nPerrotta et al. BMC Neurology (2026) 26:8  \nIntroduction  \nEpstein–Barr virus (EBV), a member of the Herpesviridae family, is a widespread pathogen that infects over 90% of adults worldwide and is typically associated with infectious mononucleosis. Neurological complications such as meningitis, encephalitis, cerebellitis, transverse myelitis and polyradiculitis are uncommon, accounting for less than 1% of all EBV infections [1–3].  \nAmong these, EBV-associated encephalitis is rare and presents with a","cbCaiq01rgKV3dGN","https://ap.wps.com/l/cbCaiq01rgKV3dGN","pdf",1183299,"English","# Abstract\n# Introduction\n# Case report","[{\"question\":\"What was the patient’s age and presenting condition in this case report?\",\"answer\":\"An 82-year-old man presented with high fever, confusion, and reduced responsiveness that progressed over 24 hours.\"},{\"question\":\"How was EBV infection confirmed, and what did the CSF show?\",\"answer\":\"EBV-DNA was detected in cerebrospinal fluid by PCR, anti-EBV IgM antibodies were positive by serology, and CSF showed mild lymphocytic pleocytosis with elevated protein and normal glucose.\"},{\"question\":\"What key MRI findings supported the diagnosis of bilateral thalamic encephalitis?\",\"answer\":\"MRI demonstrated bilateral thalamic hyperintensities on T2-weighted and FLAIR sequences, with restricted diffusion on DWI and corresponding hypointensity on ADC maps, without contrast enhancement.\"}]","Bilateral thalamic encephalitis due to Epstein–Barr virus in an elderly patient - a case report and literature review | PDF",1790715506,13]