Zoster myelitis

Abstract

This report describes two patients with acquired immunodeficiency syndrome (AIDS) and herpes zoster myelopathy. Patient one had a T-8 myelitis that preceded the onset of T-8-distribution zoster and was followed by cervical myelopathy. Antibody to varicella zoster virus (VZV) was present in the CSF. He never received steroids or other immunosuppressive drugs, and his condition improved dramatically after treatment with intravenous acyclovir. The second patient had a rapidly progressive myelitis with paralysis of both legs. Detection of VZV DNA and antibody to VZV in his CSF led to successful treatment with famciclovir despite discontinuation of dexamethasone and earlier treatment failure with acyclovir. These cases support the idea that VZV myelopathy in the immunosuppressed host is caused by virus invasion. CSF analysis for antiviral antibody and for VZV DNA by polymerase chain reaction are helpful in establishing the diagnosis. Aggressive antiviral therapy is advised.

Longitudinally Disseminated Spinal Cord Lesions (Moth-eaten Appearance) in Varicella-Zoster Myelitis

“…Axial images showed a dominant involvement of the right dorsal horn (Picture 2 A: cervical, B: thoracic, C: lumbar). These findings were quite unusual and different from the findings in previously reported cases of VZ myelitis, which is usually localized at the spinal cord segment corresponding to the dermatome involved by herpes zoster infection (1,2). In spite of intensive treatment, the patient died of multiple organ failure 23 days after admission, and autopsy was not permitted.…”

Mielopatia transversa em adulto portador de leucemia aguda linfoblástica: relato de caso

“…Por vezes, as manifestações clínicas são atípicas e podem dificultar o diagnóstico etiológico, levando a suposições enganosas, particularmente, durante a primeira avaliação clínica 14,15 . Por isso, os exames complementares são imprescindíveis na vigência de complicações neurológicas, sobretudo nas mielopatias agudas, visto que o tratamento adequado só pode ser instituído após o esclarecimento diagnós-tico 3,5,12,13,15 .…”

“…The etiologic diagnostic was obtained through peripheral blood study, bone marrow cytology, cerebrospinal fluid analysis and magnetic resonance image of the dorsal cord. The antileukemic treatment with specific drugs had no influence on the fatal outcome of the disease.KEY WORDS: acute lymphoblastic leukemia, transverse myelopathy, peripheral blood, cerebrospinal fluid, magnetic resonance image.As afecções da medula espinal são patologias frequentes do sistema nervoso central (SNC) e ocorrem na vigência de causas diversas: traumatismos, hereditariedade, processos infecciosos, neoplasias, parasitoses, doenças degenerativas, malformações congênitas, distúrbios hematológicos e doenças desmielinizantes [1][2][3][4][5][6] . Em algumas regiões, as mielopatias podem estar relacionadas às doenças endêmicas, como acontece com a esquistossomose mansônica, ainda bastante frequente na região nordeste do Brasil 7 .…”

“…As afecções da medula espinal são patologias frequentes do sistema nervoso central (SNC) e ocorrem na vigência de causas diversas: traumatismos, hereditariedade, processos infecciosos, neoplasias, parasitoses, doenças degenerativas, malformações congênitas, distúrbios hematológicos e doenças desmielinizantes [1][2][3][4][5][6] . Em algumas regiões, as mielopatias podem estar relacionadas às doenças endêmicas, como acontece com a esquistossomose mansônica, ainda bastante frequente na região nordeste do Brasil 7 .…”

Neurological Sequale of Varicella Zoster Virus Infection

“…Myelitis is one of the rarest complications of VZV infection [11][12][13][14] and usually develops in immunocompromised patients. The incidence varies from 0% to 0.8% in general population or immunocompromised patients respectively.…”