Polyneuritis cranialis and vasculopathy caused by varicella zoster virus without rash

Labbad, Ibrahim; Saleh, Yaser; Hazzouri, Belal; Samra, Dana Abou; Maksoud, Rawad

doi:10.1007/s13760-020-01395-2

Cited by 1 publication

(3 citation statements)

References 11 publications

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“…For example, the III cranial nerve involvement only manifested itself as pupil dilation without causing abnormal eye movement, and the bilateral VIII cranial nerve injuries only affected hearing but no vestibular nerve was found to be involved. The characteristics of selective polyneuritis cranialis caused by VZV has been described in several previous case reports [ 10 – 12 ]. In addition, the peculiar feature that the brain MRI of VZV-induced polyneuritis cranialis is often negative has also been described before [ 12 ], which was consistent with our current findings.…”

Section: Discussionmentioning

confidence: 90%

“…The characteristics of selective polyneuritis cranialis caused by VZV has been described in several previous case reports [ 10 – 12 ]. In addition, the peculiar feature that the brain MRI of VZV-induced polyneuritis cranialis is often negative has also been described before [ 12 ], which was consistent with our current findings. This feature helps to rule out the occurrence of both tuberculous meningitis and sarcoidosis.…”

Section: Discussionmentioning

confidence: 90%

“…Polyneuritis cranialis (VII, VIII, IX, X) caused by VZV have also been described before [ 10 , 11 ]. Moreover, previously, it was reported that a 41-year-old female with polyneuritis cranialis (III, VII, VIII) was diagnosed with VZV infection due to the positive detection of anti-VZV IgG in CSF [ 12 ]. In our case, the patient suffered from the multiple cranial nerve injuries, including that of the right oculomotor nerve, bilateral facial nerves and vestibulocochlear nerves (III, VII, VIII).…”

Section: Discussionmentioning

confidence: 99%

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Acute myelitis with multicranial neuritis caused by Varicella zoster virus: a case report

Liu

Zhou

2022

BMC Neurol

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Background Varicella zoster virus (VZV) can remain lifelong in the latent state in ganglionic neurons and adrenal glands after the initial infection. However, it can be reactivated anytime and can trigger several severe neurological manifestations such as encephalitis, meningitis, Ramsay-Hunt syndrome, cerebellitis, myelitis, and stroke. In addition, due to the diversity of clinical manifestations, clinical diagnosis of VZV can be difficult, especially in the absence of varicella. Here, we describe the case of a 52-year-old male who presented with symptoms of acute myelitis as well as polycranial neuritis, and was finally diagnosed with VZV infection through metagenomic next-generation sequencing (mNGS). Case presentation A 52-year-old male came to our hospital with complaint of headache, fever, weakness of right lower limb, abdominal distension, and hearing loss. T2-weighted MRI revealed a hyperintense lesion in the spinal cord extending from T8 to T11. In addition, enhanced MRI showed small patches and strips hyperintensities in both the spinal cord and meninges. Plain abdominal radiographs and abdominal computed tomography (CT) scan displayed air-fluid levels and incomplete bowel obstruction. Moreover, electrophysiological evaluation of the peripheral neuropathy in the extremities was found to be normal. Finally, by using metagenomic next-generation sequencing (mNGS) we found that the copy number of VZV DNA in cerebrospinal fluid (CSF) was significantly increased and IgG antibody against VZV in CSF was also noted to be positive. Hence, VZV infection was identified in patient’s central neuron system. Finally, after a few days of low dose steroid treatment, the patient's symptoms were found to be significantly improved. Conclusions The findings indicate that we should pay proper attention to the various symptoms caused by VZV infection due to the clinical heterogeneity, especially in the absence of cutaneous lesions.

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Section: Discussionmentioning

confidence: 90%