Mononucleosis, or mono, is a common viral infection primarily known for causing symptoms like swollen lymph glands, fever, a sore throat, and extreme fatigue. This illness is frequently transmitted through saliva, leading to its popular nickname, “the kissing disease.” While mono is generally a self-limiting condition, meaning it resolves on its own, it is important to understand that in rare instances, it can be associated with more serious complications, including seizures.
Understanding Mono’s Impact on the Brain
Mono is predominantly caused by the Epstein-Barr virus (EBV), a widespread human herpesvirus. Although the infection commonly affects the lymphatic system and other organs, EBV can, in some cases, extend its reach to the central nervous system, which includes the brain and spinal cord. This neurological involvement is uncommon, occurring in less than 1% of mono cases.
When EBV affects the brain, it can lead to conditions such as encephalitis (inflammation of the brain tissue) or meningitis (inflammation of the protective membranes surrounding the brain and spinal cord). These neurological complications are rare manifestations of mono.
Specific Ways Mono Can Trigger Seizures
Seizures can arise in mono through several distinct mechanisms. One way is through direct viral invasion, where the Epstein-Barr virus enters and affects nerve tissue. This direct impact on brain cells can disrupt normal electrical activity, potentially lowering the seizure threshold.
The body’s immune response to the virus can also play a role, leading to significant brain inflammation. This immune-mediated inflammation, often referred to as post-infectious encephalitis, can directly contribute to seizure activity by interfering with the brain’s normal electrical signaling pathways.
Another contributing factor can be severe electrolyte imbalances, particularly hyponatremia, which is a dangerously low level of sodium in the blood. Low sodium levels can cause water to shift into brain cells, leading to brain swelling, also known as cerebral edema. This swelling increases pressure within the skull, disrupting the brain’s normal function and making it susceptible to seizures. Seizures due to hyponatremia are more likely if sodium levels fall below 115 mEq/L.
Recognizing and Responding to Seizures
Recognizing the signs of a seizure is important for providing timely assistance. Symptoms can vary, but commonly include short-lived confusion, staring spells, or uncontrollable jerking movements of the arms and legs. A person may also experience a loss of consciousness or awareness, or exhibit sudden changes in emotions or sensations. Sometimes, muscles may become stiff or completely limp.
If someone experiences a seizure, staying calm and ensuring their safety are the immediate steps. Gently ease the person to the ground if they appear to be falling. Turn them carefully onto one side with their mouth pointing downwards to help keep their airway clear. Clear the area around them of any objects that could cause injury. Place something soft, like a jacket or cushion, under their head for protection.
Do not attempt to restrain the person or place anything in their mouth, as this can cause harm. Time the duration of the seizure. Seek urgent medical attention by calling emergency services if:
- The seizure lasts longer than five minutes.
- Repeated seizures occur.
- The person has difficulty breathing.
- They are injured during the seizure.
- It is their first seizure.
Recovery and Long-Term Outlook
For individuals who experience neurological complications, including seizures, in the context of mononucleosis, the outlook is generally positive. Most complications are temporary and resolve with appropriate medical management. Recovery typically involves gradual improvement over several months.
While seizures can be distressing, long-term neurological deficits following mono-related complications are rare. The Epstein-Barr virus remains dormant after the initial infection, typically not causing recurring illness or complications unless the immune system weakens. Medical professionals can provide guidance and support throughout recovery.