Urinary Retention as an Initial Symptom of Acute Meningo-Encephalo-Radiculitis in Epstein-Barr Virus Infection

A 48-year-old man presented with urinary retention followed by disturbance of consciousness, areflexia, ophthalmoplegia, muscle weakness, and atrophy. Epstein-Barr virus DNA by PCR was positive in his cerebrospinal fluid. The cerebrospinal fluid revealed elevated myelin basic protein and an oligoclonal band. Magnetic resonance imaging showed high signal intensity in the pons, basal ganglia, and cerebral white matter on T2-weighted imaging and fluid-attenuated inversion recovery imaging. His consciousness, ophthalmoplegia, and muscle weakness almost full recovered. In this patient, the inflammation is thought to have begun as sacral radiculitis, and then extended to encephalitis, and brachial and lumbar radiculoneuritis.