Russman Andrew N, Lederman Richard J, Calabrese Leonard H, Embi Peter J, Forghani Bagher, Gilden Donald H
Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Arch Neurol. 2003 Nov;60(11):1607-9. doi: 10.1001/archneur.60.11.1607.
A 51-year-old woman with CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) developed stepwise progressive focal neurological deficits without zoster rash. Multifocal ischemic infarcts were seen on magnetic resonance imaging, and cerebral angiography revealed focal stenosis of arteries affecting the intracranial circulation. A brain biopsy was nondiagnostic. Virological etiology of the disease was verified by the detection of varicella-zoster virus antibody in cerebrospinal fluid and by reduced serum-cerebrospinal fluid varicella-zoster virus IgG ratios (compared with normally high ratios of total IgG and albumin). Treatment with intravenous acyclovir stabilized but did not significantly improve her neurological deficits.
一名患有CREST综合征（钙质沉着、雷诺现象、食管动力障碍、指端硬化和毛细血管扩张）的51岁女性，出现了逐步进展的局灶性神经功能缺损，且无带状疱疹皮疹。磁共振成像显示有多发性缺血性梗死，脑血管造影显示影响颅内循环的动脉出现局灶性狭窄。脑活检未得出诊断结果。通过检测脑脊液中的水痘-带状疱疹病毒抗体以及降低血清-脑脊液水痘-带状疱疹病毒IgG比值（与正常情况下总IgG和白蛋白的高比值相比），证实了该疾病的病毒学病因。静脉注射阿昔洛韦治疗使病情稳定，但并未显著改善她的神经功能缺损。
