Nakane S, Honda H, Hamasaki S, Shirabe S, Nakamura T
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
No To Shinkei. 2000 Jan;52(1):43-7.
We describe here a 71-year-old man who had herpes zoster encephalitis. He developed high fever, headache and disturbance of consciousness on 1st, May, 1998. On admission, neurological examination revealed disturbance of consciousness with restlessness and meningeal signs. Brain MRI (T 1 and T 2 weighted images) demonstrated high signal lesions in the left temporal lobe and cerebellar vermis. VSV encephalitis was diagnosed based on CSF pleocytosis, high serum and CSF titers of VZV antibody and EEG abnormality. During hospitalization, Ramsay-Hunt syndrome, herpes zoster generalisatus and acute pancreatitis developed. To our knowledge, the characteristic combination of the clinical signs in this case is very rare. We discussed the pathogenic mechanisms of these conditions, and this case was considered to have VZV encephalitis, and to be associated with right facial nerve palsy and pancreatitis, in spite of the absence of immunological deficiency.
我们在此描述一位患有带状疱疹性脑炎的71岁男性。他于1998年5月1日出现高热、头痛及意识障碍。入院时，神经系统检查发现意识障碍伴烦躁不安及脑膜刺激征。脑部MRI（T1加权像和T2加权像）显示左侧颞叶及小脑蚓部有高信号病灶。根据脑脊液细胞增多、血清和脑脊液中水痘-带状疱疹病毒（VZV）抗体滴度升高以及脑电图异常，诊断为VSV脑炎。住院期间，出现了拉姆齐-亨特综合征、泛发性带状疱疹及急性胰腺炎。据我们所知，该病例中这些临床体征的特征性组合非常罕见。我们讨论了这些病症的发病机制，尽管该病例没有免疫缺陷，但仍被认为患有VZV脑炎，并伴有右侧面神经麻痹和胰腺炎。
