Varicella-Zoster-Mediated Radiculitis Reactivation following Cervical Spine Surgery: Case Report and Review of the Literature

Drazin, Doniel; Hanna, George; Shweikeh, Faris; Jeswani, Sunil; Lovely, Leah; Sokolov, Richard; Liu, John C.

doi:10.1155/2013/647486

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…Similarly there are very few data for VZV/HHV3 and HHV6-8 during critical illness. VZV has been reported following spinal surgery but otherwise remains understudied in critically ill patients (81, 144–147). As with other HHV, aberrations in cell-mediated immunity are thought to be one of the causes of VZV reactivation (148, 149).…”

Section: Virusesmentioning

confidence: 99%

Resistant Pathogens, Fungi, and Viruses

Guidry

Mansfield

Sawyer

et al. 2014

Surgical Clinics of North America

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The first reports of antibiotic pathogens occurred a few short years after the introduction of these powerful new agents, heralding a new kind of war between medicine and pathogens. Although originally described in Staphylococcus aureus, resistance among bacteria has now become a grim race to determine which classes of bacteria will become more resistant, pitting the Gram positive staphylococci, enterococci, and streptococci against the increasingly resistant Gram negative pathogens, e. g., carbapenemase-resistant enterobacteriaceae. In addition, the availability of antibacterial agents has allowed the development of whole new kinds of diseases caused by non-bacterial pathogens, related largely to fungi that are inherently resistant to antibacterials. All of these organisms are becoming more prevalent and, ultimately, more clinically relevant for surgeons. It is ironic that despite their ubiquity in our communities, there is seldom a second thought given to viral infections in patients with surgical illness. The extent of most surgeon’s interest in viral infections ends with hepatitis and HIV, no doubt related to transmissibility as well as the implications that these viruses might have in a patient’s hepatic or immune functions. There are chapters and even textbooks written about these viruses so these will not be considered here. Instead, we will present the growing body of knowledge of the herpes family viruses and their occurrence and consequences in patients with concomitant surgical disease or critical illness. We have also chosen to focus this chapter on previously immune competent patients, as the impact of herpes family viruses in immunosuppressed patients such as transplant or AIDS patients has received thorough treatment elsewhere.

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Section: Virusesmentioning

confidence: 99%

Resistant Pathogens, Fungi, and Viruses

Guidry

Mansfield

Sawyer

et al. 2014

Surgical Clinics of North America

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“…They usually present unilaterally and affect a single or very few levels, manifesting as dermatomal pain and vesicular eruption (post-herpetic neuralgia) years after the primary infection and therefore unlikely to be related to our patient's presentation. 27,28 Also, radiculitis may be associated with weakness unlike our case. 29 Finally, as stated above, the denervation potentials seen on follow up EMG indicate subclinical involvement of motor axons, therefore they exclude sensory neuronopathy.…”

Section: Discussionmentioning

confidence: 47%

<p>A Rare Case with New Insights: Pure Sensory Guillain Barre Syndrome with Axonal Features</p>

Kofahi

Aldabbour

Aljezawi

2020

IMCRJ

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The pure sensory variant of Guillain-Barré syndrome "GBS" is controversial. Scarce case reports in the literature have described pure sensory presentations secondary to acute demyelination of peripheral sensory nerves. Pure sensory GBS secondary to axonal damage is rarer and even more controversial owing to a significant overlap with sensory neuronopathy. A 31-year-old lady with history of a recent primary varicella zoster virus (VZV) infection presented with acute onset of sensory symptoms and signs involving her four limbs and the trunk, without weakness. Examination was remarkable for severe impairment in all sensory modalities in her limbs and trunk, pseudo-athetoid limb movements, sensory ataxia, positive Romberg's sign, and areflexia, with no motor involvement. CSF analysis showed elevated protein without pleocytosis known as albuminocytological dissociation. MRI of the spine with contrast showed multiple root enhancement. Nerve conduction studies "NCS" demonstrated absent sensory action potentials, with normal motor nerves responses. Initial electromyography was normal. After differential diagnoses were appropriately excluded, the patient was diagnosed with pure sensory axonal GBS and treated with IVIG for five days. Gradual clinical improvement was seen over the following months, with improvement in six-month GBS disability score down to two. Follow-up NCS showed findings similar to the initial study but follow-up EMG studies revealed denervation potentials in multiple levels, suggesting a subclinical axonal motor involvement and excluding sensory neuronopathy. To our best knowledge, this case represents the first case of pure sensory GBS with onset after a documented primary VZV infection. The findings in this case illustrate the difficulties in diagnosing pure sensory GBS and the significance of an early treatment. It also demonstrates the potential value of follow-up EMGs in excluding sensory neuronopathy as an important differential diagnosis for this condition.

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“…W wielu badaniach klinicznych wykazano skuteczność nortryptyliny i amitryptyliny [17]. Ponadto istnieją doniesienia, że środki neuromodulujące, takie jak gabapentyna, zapobiegają lub zmniejszają nasilenie nerwobólu związanego z HZ [27]. Zdaniem Drazin i wsp.…”

Section: Profilaktyka I Leczenie Neuralgii Postherpetycznejunclassified

“…Zdaniem Drazin i wsp. [27] wcześnie rozpoczę-te leczenie przeciwwirusowe w połączeniu z lekami neuromodulującymi (nortryptylina) złagodziło ostre objawy i zapobiegło długotrwałym następstwom infekcji VZV po zabiegu neurochirurgicznym u 41-letniego pacjenta.…”

Section: Profilaktyka I Leczenie Neuralgii Postherpetycznejunclassified

Prophylaxis and treatment of acute and chronic postherpetic neuralgia

Michalska-Bańkowska¹,

Lis‐Święty²,

Bańkowski³

et al. 2014

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STRESZCZENIEPółpasiec (herpes zoster -HZ) jest chorobą wywoływaną przez wirus ospy wietrznej i HZ (varicella-zoster virus -VZV), który przy pierwszym kontakcie zwykle prowadzi do zachorowania na ospę wietrzną. W sytuacji zmniejszonej odporności organizmu może dojść do reaktywacji wirusa i wystąpienia objawów HZ. Charakteryzuje się on zmianami pęcherzykowymi i pęcherzowymi umiejscowionymi jednostronnie, którym towarzyszą dolegliwości bólowe. Największe problemy diagnostyczne występują w przypadku postaci zoster sine herpete oraz HZ o przebiegu bezbólowym. Istotnym powikłaniem przebytej ostrej infekcji HZ jest przewlekła neuralgia (ang. postherpetic neuralgia -PHN), która objawia się występowaniem tępego i palącego bólu w ciągu co najmniej 3 miesięcy od pojawienia się osutki. Podeszły wiek, płeć żeń-ska, obecność ciężkich objawów prodromalnych, większe nasilenie zmian skórnych, zaburzenia czucia i ostre nasilenie bólu w początko-wej fazie infekcji HZ predysponują do przewlekłej PHN. Wczesna diagnoza infekcji HZ i zastosowanie leków przeciwwirusowych zmniejsza ryzyko wystąpienia PHN. W leczeniu ostrej PHN bardzo dobrym rozwiązaniem są miejscowe środki znieczulające. Trójpierścieniowe leki przeciwdepresyjne (nortryptylina, amitryptylina) to standardowe leki, które łagodzą ból w podostrej PHN. Środki neuromodulujące, takie jak gabapentyna, pozwalają zapobiec lub zmniejszyć nasilenie nerwobólu związanego z HZ. Inne opcje lecznicze to: ablacja nerwów prądem o częstotliwości radiowej (ang. radiofrequency ablation -RFA), przezskórna elektryczna stymulacja nerwów (ang. transcutaneous electrical nervous stimulation -TENS), a także metody fizykalne, takie jak magneto-oraz laseroterapia. Oczekuje się, że zastosowanie u osób powyżej 60. roku życia żywej atenuowanej szczepionki zahamuje rozwój HZ i zapobiegnie przewlekłej PHN, która częściej występuje u osób w podeszłym wieku. ABSTRACTHerpes zoster (HZ) is a disease caused by varicella zoster virus (VZV), where the initial contact leads to varicella. The low immunity of the patient might reactivate the virus and provoke symptoms of HZ, which is characterized by vesicles and blisters localized unilaterally and accompanied by pain. The greatest diagnostic problems occur in zoster sine herpete and painless HZ. A significant complication of acute HZ SŁOWA KLUCZOWE:Zoster sine herpete, nerwoból poopryszczkowy, diagnostyka. KEY WORDS:Zoster sine herpete, postherpetic neuralgia, diagnostic.

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Varicella-Zoster-Mediated Radiculitis Reactivation following Cervical Spine Surgery: Case Report and Review of the Literature

Cited by 8 publications

References 11 publications

Resistant Pathogens, Fungi, and Viruses

Resistant Pathogens, Fungi, and Viruses

<p>A Rare Case with New Insights: Pure Sensory Guillain Barre Syndrome with Axonal Features</p>

Prophylaxis and treatment of acute and chronic postherpetic neuralgia

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