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- W1577996899 abstract "OBJECTIVE: Uncommon varied neurological presentations of VZVBACKGROUND:Meningoencephalitis with VZV is rare. It can be seen in immunocompetent and immunocompromised patients.Neurological symptoms in the absence of the rash are rare.Making a diagnosis in the absence of recent dermatomal distribution of rash can be challenging.METHODS:50 year old female experienced urinary and bowel retention with numbness of heel for three days. She had a painful vesicular eruption on her right thigh eight weeks earlier. MRI of the neuraxis was normal.VZV PCR was positive in the CSF. Her neurological symptoms resolved with IV Acyclovir.23 year old woman came with urinary retention, weakness, numbness of right leg and abdomen. Three months earlier she had steroids and Azathioprine for systemic lupus erythmatosus. Exam showed weakness of tongue, left leg with decreased pin prick up to T8 level. Serum VZV antibodies were positive. MRI showed restricted diffusion in the medulla and temporal lobe.She received steroids and IVIG. A month later she developed fever, retinal necrosis and vesicular rash on left forearm which was positive for VZV antibody. Patient improved neurologically on oral Valacyclovir.84 year old male had radicular thoracic pain, urinary and bowel incontinence for one week. Examination showed isolated weakness of lower extremities. MRI of the thoracolumbar spine showed an intradural, intramedullary edematous enhancing lesion at the T7-T8 level. Biopsy showed inflammation and gliosis with no cellular atypia. Autopsy revealed brainstem and spinal cord necrosis, along with Cowdry viral inclusions consistent with VZV.CONCLUSION:VZV related neurological complications can occur in the absence or eight weeks prior or four weeks after the rash. The above mentioned cases highlight atypical presentation of VZV infection. VZV infection can present as unexplained myelopathy, mass lesion, restricted diffusion changes or unusual CNS symptoms.1) Bauman ML etal. Postvaricella encephalitis. Arch Neurol 1984; 556-8.2) Gray F etal. VZV infection of the central nervous system in the AIDS . Brain 1994; 117:987-99. Disclosure: Dr. Javed has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Marks has received personal compensation for activities with Boehringer-Ingelheim Pharmaceuticals Inc. as a speaker. Dr. Sahni has nothing to disclose. Dr. Ahluwalia-Singh has nothing to disclose." @default.
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- W1577996899 date "2014-04-08" @default.
- W1577996899 modified "2023-09-23" @default.
- W1577996899 title "Neurological Sequelae of Varicella Zoster Virus Infection ( VZV): Case Series of Varied Presentations (P6.022)" @default.
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