Bilateral Thalamic Encephalitis due to Epstein–Barr Virus in an Elderly Patient: A Case Report and Literature Review
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Bilateral thalamic encephalitis caused by Epstein–Barr virus (EBV) is a rare manifestation, characterized by severe clinical presentation and often unfavorable prognosis.We report the case of an 82-year-old man with a history of arterial hypertension and previous herpes zoster infection, who presented high fever and a progressive neurological deterioration culminating in a coma with Glasgow Coma Scale (GCS) of 3.The patient had initially been treated for a suspected urinary tract infection.In the intensive care unit, cerebrospinal fluid (CSF) analysis revealed EBV-DNA positivity, and serology confirmed positive anti-EBV IgM. Brain MRI showed bilateral thalamic hyperintense lesions on DWI and T2/FLAIR sequences. We discuss the clinical presentation, differential diagnosis, and therapeutic implications in the context of the available literature.
