Abstract
Amaç: Varisella zoster virus (VZV) enfeksiyonları primer enfeksiyon veya reaktivasyon dönemlerinde çeşitli nörolojik sendromlara neden olabilmektedir. Burada VZV ile ilişkili, eş zamanlı transvers miyelit ve Guillain Barré sendromu gelişen olguyu sunmayı amaçladık. Olgu: Yetmiş altı yaşında kadın hasta tüm vücutta suçiçeği ile uyumlu cilt lezyonları ve 10 gün önce başlayan yürüme güçlüğü şikayetleriyle başvurdu. Nörolojik muayenede paraparezi ve arefleksi görüldü. Spinal kord manyetik rezonans görüntülemede alt servikal ve torakal düzeyi tutan uzun segment transvers miyelit lezyonu izlendi. Beyin omurilik sıvısında, protein yüksekliği ve VZV DNA varlığı, serumda VZV IgM saptandı. İki gün sonra hastanın bacaklarındaki güçsüzlüğü arttı. Elektromiyografide akut aksonal motor polinöropati bulguları görüldü. Hasta yüksek doz steroid ve antiviral tedavi ardından intravenöz immunglobulin ile tedavi edildi. Kısmi iyileşme izlendi. Sonuç: Transvers miyelit ve Guillain Barré sendromu, VZV enfeksiyonunun nadir görülen komplikasyonlarıdır. Olgumuz VZV ile ilişkili bu iki nörolojik durumun aynı hastada görüldüğü ilk vakadır.
Keywords
Varisella Zoster Virus akut enflammatuar demiyelinizan polinöropati Guillain Barré Sendromu Transvers Miyelit suçiçeği
References
- Referans1.Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347:340-6.
- Referans2.Skripuletz T, Pars K, Schulte A, Schwenkenbecher P, Yildiz Ö, Ganzenmueller T et al. Varicella zoster virus infections in neurological patients: a clinical study. BMC Infect Dis. 2018;18:238. Referans3.Chamizo FJ, Gilarranz R, Hernández M, Ramos D, Pena MJ. Central nervous system infections caused by varicella-zoster virus. J Neurovirol. 2016;22:529-32. Referans4.Ong OL, Churchyard AC, New PW. The importance of early diagnosis of herpes zoster myelitis. Med J Aust. 2010;193:546-7.
- Referans5.Lee CC, Wu JC, Huang WC, Shih YH, Cheng H. Herpes zoster cervical myelitis in a young adult. J Chin Med Assoc. 2010;73:605-10.
- Referans6.Devinsky O, Cho ES, Petito CK, Price RW. Herpes zoster myelitis. Brain. 1991;114:1181-96.
- Referans7.Gilden DH, Bennett JL, Kleinschmidt-DeMasters BK, Song DD, Yee AS, Steiner I. The value of cerebrospinal fluid antiviral antibody in the diagnosis of neurologic disease produced by varicella zoster virus. J Neurol Sci. 1998;159:140-4.
- Referans8.Wang X, Zhang X, Yu Z, Zhang Q, Huang D, Yu S. Long-term outcomes of varicella zoster virus infection-related myelitis in 10 immunocompetent patients. J Neuroimmunol. 2018;321:36-40. Referans9.Islam B, Islam Z, GeurtsvanKessel CH, Jahan I, Endtz HP, Mohammad QD et al. Guillain-Barré syndrome following varicella-zoster virus infection. Eur J Clin Microbiol Infect Dis. 2018;37:511-8.
Abstract
Aim: Varicella zoster virus (VZV) infections can cause various neurological syndromes during primary infection or reactivation periods. We report two rare neurological complications of VZV, acute longitudinally extensive myelitis and acute motor axonal neuropathy due to primary chickenpox infection that occurred concomitantly. Case: A 76-year-old female patient presented with skin lesions consistent with chickenpox all over the body and walking difficulty ten days ago. Neurological examination revealed paraparesis and areflexia. Spinal cord magnetic resonance imaging revealed a long-segment transverse myelitis lesion involving the lower cervical and thoracic levels. Elevated protein and the presence of VZV DNA were detected in the cerebrospinal fluid, and VZV IgM was detected in the serum. Two days later, the patient's weakness in her legs increased. Electromyography showed signs of acute axonal motor polyneuropathy. The patient was treated with intravenous immunoglobulin after high-dose steroid and antiviral therapy. Partial recovery was observed. Conclusion: Transverse myelitis and Guillain Barré syndrome are rare complications of VZV infection. Our case is first case where these two neorological conditions related to VZV were seen in the same patient.
Keywords
varicella zoster virus acute inflammatory demyelinating polyneuropathy Guillain Barre Syndrome Transvers myelitis chickenpox
References
- Referans1.Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347:340-6.
- Referans2.Skripuletz T, Pars K, Schulte A, Schwenkenbecher P, Yildiz Ö, Ganzenmueller T et al. Varicella zoster virus infections in neurological patients: a clinical study. BMC Infect Dis. 2018;18:238. Referans3.Chamizo FJ, Gilarranz R, Hernández M, Ramos D, Pena MJ. Central nervous system infections caused by varicella-zoster virus. J Neurovirol. 2016;22:529-32. Referans4.Ong OL, Churchyard AC, New PW. The importance of early diagnosis of herpes zoster myelitis. Med J Aust. 2010;193:546-7.
- Referans5.Lee CC, Wu JC, Huang WC, Shih YH, Cheng H. Herpes zoster cervical myelitis in a young adult. J Chin Med Assoc. 2010;73:605-10.
- Referans6.Devinsky O, Cho ES, Petito CK, Price RW. Herpes zoster myelitis. Brain. 1991;114:1181-96.
- Referans7.Gilden DH, Bennett JL, Kleinschmidt-DeMasters BK, Song DD, Yee AS, Steiner I. The value of cerebrospinal fluid antiviral antibody in the diagnosis of neurologic disease produced by varicella zoster virus. J Neurol Sci. 1998;159:140-4.
- Referans8.Wang X, Zhang X, Yu Z, Zhang Q, Huang D, Yu S. Long-term outcomes of varicella zoster virus infection-related myelitis in 10 immunocompetent patients. J Neuroimmunol. 2018;321:36-40. Referans9.Islam B, Islam Z, GeurtsvanKessel CH, Jahan I, Endtz HP, Mohammad QD et al. Guillain-Barré syndrome following varicella-zoster virus infection. Eur J Clin Microbiol Infect Dis. 2018;37:511-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | March 30, 2023 |
| Submission Date | November 30, 2022 |
| Published in Issue | Year 2023 Volume: 2 Issue: 1 |
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