Epstein-Barr Virus and Cerebral Vein Thrombosis

Introduction Glandular fever and seizures are both relatively common clinical conditions affecting younger patients. Generally, acute Epstein-Barr virus (EBV) infection does not require any medical therapy. A first isolated seizure is often managed conservatively. When both glandular fever and a first seizure present together, an inpatient computed tomography and magnetic resonance imaging may need to be performed. Case Presentation In this report, we describe a fit and well 21-year-old man presenting with a first episode of a generalized tonic-clonic seizure, spontaneously terminating without any treatment. On admission, he complained of a 2-week history of sore throat, fever, and malaise. History and laboratory findings were consistent with acute EBV infection (glandular fever). Subsequent computed tomography and magnetic resonance imaging venography scan revealed a venous angioma with probable thrombosis of the main draining cortical vein. He was found to be positive for antiphospholipid (APL) antibody. Conclusion There is recognition of viruses inducing APL antibodies, and EBV has been implicated. This is the first case report in the English literature where EBV may have played a role in thrombosis of the cortical vein via the induction of APL antibodies presenting as a seizure.