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Parkinson-like syndrome as the major presenting symptom of Epstein–Barr virus encephalitis

The main symptoms of Epstein–Barr virus encephalitis (EBV) encephalitis are fever, seizure, bizarre behaviour, headache, and metamorphosia.1 Bradykinesia, akathisia, involuntary hand movements, drooling, and torticollis are symptoms of Parkinson-like syndrome, which has never been described as a manifestation of EBV encephalitis.

We report the case of a previously healthy boy who presented with Parkinson-like syndrome as the major symptom of EBV encephalitis.

A 12 year old, previously healthy boy was referred to our hospital because of severe cough with sputum and intermittent fever for seven days. Abdominal discomfort and vomiting were also noted one day before admission.

On admission, his consciousness was clear with no focal neurological sign, no hepatosplenomegaly, no lymphoadenopathy, and no exudative tonsillitis or skin rash. There was no previous personal or family history of seizure disorder or migraine, and both the boy and his family denied being exposed to some possible hallucinogenic or neuroleptic drug. Blood