A Rare Presentation of Cranial Polyneuropathy Without Rash Caused by Varicella Zoster Virus

Med Arch. 2017 Aug;71(4):293-295. doi: 10.5455/medarh.2017.71.293-295.

Abstract

Introduction: Varicella Zoster Virus (VZV) is associated with many disorders of the central and peripheral nervous systems including neuralgia, meningitis, meningoencephalitis, cerebellitis, vasculopathy, myelopathy, Ramsay-Hunt syndrome, and polyneuritis cranialis. Cranial nerves V, VI, VII, VIII, IX, X, XI, and/or XII may be affected. The neurological disorders caused by VZV usually present with rash, but may rarely present without rash.

Case report: We herein present a case of polyneuritis cranialis without rash caused by VZV affecting cranial nerves VII, VIII, IX, and X. After excluding other causes of the condition, we diagnosed VZV infection based on VZV DNA in the CSF and an elevated anti-VZV IgG level in serum. The patient responded well to antiviral therapy.

Conclusion: VZV infection should be kept in mind during the differential diagnosis of polyneuritis cranialis; it is important to note that VZV re-activation may occur without rash.

Keywords: Cranial Polyneuropathy; Varicella Zoster Virus.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Cranial Nerve Diseases / drug therapy
  • Cranial Nerve Diseases / physiopathology
  • Cranial Nerve Diseases / virology*
  • Facial Nerve Diseases / drug therapy
  • Facial Nerve Diseases / physiopathology
  • Facial Nerve Diseases / virology*
  • Herpes Zoster / complications*
  • Herpes Zoster / virology
  • Herpesvirus 3, Human* / physiology
  • Humans
  • Male
  • Middle Aged
  • Neuralgia, Postherpetic / drug therapy
  • Neuralgia, Postherpetic / physiopathology
  • Neuralgia, Postherpetic / virology*
  • Polyneuropathies / drug therapy
  • Polyneuropathies / physiopathology
  • Polyneuropathies / virology*
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Acyclovir