Gilden Don, Nagel Maria A, Ransohoff Richard M, Cohrs Randall J, Mahalingam Ravi, Tanabe Jody L
Department of Neurology, University of Colorado Denver, School of Medicine, Denver, CO, USA.
J Neurol Sci. 2009 Jan 15;276(1-2):196-8. doi: 10.1016/j.jns.2008.09.025. Epub 2008 Oct 21.
Myelopathy is an uncommon complication of VZV infection and may develop in the absence of rash. We report the rare recurrence of myelopathy in an immunocompetent adult who initially developed myelopathy after ophthalmic-distribution zoster. Recurrent myelopathy two years later caused by VZV was verified by the presence of new-onset clinical symptoms and signs consistent with myelopathy, new lesions in the spinal cord detected by MRI, and evidence of intrathecal synthesis of anti-VZV IgG antibody in CSF. After virological verification and antiviral therapy, myelopathy did not recur and anti-VZV IgG antibody could not be detected in CSF. In contrast to earlier cases of recurrent VZV myelopathy in immunocompetent adults that developed weeks to months after the first episode of myelopathy, this is the first instance of recurrence years later.
脊髓病是水痘-带状疱疹病毒（VZV）感染的一种罕见并发症，可在无皮疹的情况下发生。我们报告了一例免疫功能正常的成年人脊髓病罕见复发的病例，该患者最初在眼部带状疱疹后发生脊髓病。两年后由VZV引起的复发性脊髓病通过出现与脊髓病一致的新发临床症状和体征、MRI检测到脊髓新病变以及脑脊液中抗VZV IgG抗体鞘内合成的证据得到证实。经过病毒学验证和抗病毒治疗后，脊髓病未复发，脑脊液中也未检测到抗VZV IgG抗体。与免疫功能正常的成年人早期复发性VZV脊髓病病例在首次脊髓病发作后数周或数月出现不同，这是数年后复发的首例。
