Abstract
A 19 year-old man presented with pharyngitis and cervical lymphadenopathy, followed by vomitmg and acute cerebellar ataxia. Serologic studies were consistent with a recent Epstein-Barr virus infection. Although contrast-enhanced brain computed tomography and MRI scans were normal, brain perfusion single photon emission tomography (SPECT) examination using 99mTc-HMPAO, performed on the 15th day of illness, showed marked cerebellar hyperperfusion, suggesting a diagnosis of acute post-infectious cerebellitis. After treatment with intravenous human immunoglobulin (IVlg, 2 g kg-1 over three days), progressive neurologic improvement occurred over two weeks. A brain SPECT study repeated after two additional weeks demonstrated a normal perfusion pattern. We conclude that brain perfusion SPECr examination is useful in identifying post-infectious cerebellitis and in monitoring its clinical course. In addition, IVlg may be helpful in treating this condition. [Neural Res 1998; 20: 85–88].
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