A case of polyradiculoneuritis associated with disseminated herpes zoster
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- M.D. Shoji Hiroshi
- Department of Neurology, St. Mary’s Hospital
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- M.D. Fukuda Kenji
- Department of Cerebrovascular Medicine, St. Mary’s Hospital
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- M.D. Yano Arisa
- Department of Dermatology, St. Mary’s Hospital
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- M.D. Abe Toshifumi
- Department of Dermatology, St. Mary’s Hospital
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- M.D. Oguri Shuichi
- Department of Radiology, St. Mary’s Hospital
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- M.D. Baba Masayuki
- Department of Neurology, Aomori Prefectural Central Hospital
Bibliographic Information
- Other Title
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- 播種性帯状疱疹に伴う多発根神経炎の1例
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Description
<p>A 34-year-old man developed right-dominant lower limb paraplegia, and then upper limb paresis with radicular pain following disseminated herpes zoster (HZ) in his right forehead, back of the trunk, and lumbar and right lower limb regions. Cerebrospinal fluid (CSF) findings revealed an increase in lymphocytes (32 cells/μl) and protein content (50 mg/dl), and polymerase chain reaction (PCR) for varicella-zoster virus (VZV) DNA was negative in CSF, but VZV antigen was positive in the patient’s vesicle smear. Lumbar root MRI using 3D Nerve VIEW (Philips) imaging showed high-intensity lesions on the L2–L5 spinal roots with contrast enhancements, and cervical MRI showed similar findings on both sides at the C4–Th1. Peripheral nerve conduction study revealed prolonged distal latency to 4.9 ms, decreased MCV to 38 m/s, and complete loss of F-wave was seen in the right peroneal nerve study. Minimal F-wave latency was prolonged in the right tibial nerve. Thus, the patient was diagnosed with VZV polyradiculoneuritis caused by disseminated HZ. Regarding the possible pathogenesis of polyradiculoneuritis in this patient with disseminated HZ, we speculate that VZV reached by retrograde transmission from the involved peripheral nerves to the spinal ganglia, which, then, produced polyradiculoneuritis.</p>
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 60 (11), 786-790, 2020
Societas Neurologica Japonica
