Departments of Neurology, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.
Curr Top Microbiol Immunol. 2010;342:243-53. doi: 10.1007/82_2009_3.
Reactivation of varicella zoster virus (VZV) from latently infected human ganglia usually produces herpes zoster (shingles), characterized by dermatomal distribution pain and rash. Zoster is often followed by chronic pain (postherpetic neuralgia or PHN) as well as meningitis or meningoencephalitis, cerebellitis, isolated cranial nerve palsies that produce ophthalmoplegia or the Ramsay Hunt syndrome, multiple cranial nerve palsies (polyneuritis cranialis), vasculopathy, myelopathy, and various inflammatory disorders of the eye. Importantly, VZV reactivation can produce chronic radicular pain without rash (zoster sine herpete), as well as all the neurological disorders listed above without rash. The protean neurological and ocular disorders produced by VZV in the absence of rash are a challenge to the practicing clinician. The presentation of these conditions varies from acute to subacute to chronic. Virological confirmation requires the demonstration of amplifiable VZV DNA in cerebrospinal fluid (CSF) or in blood mononuclear cells, or the presence of anti-VZV IgG antibody in CSF or of anti-VZV IgM antibody in CSF or serum.
水痘带状疱疹病毒（VZV）从潜伏感染的人神经节中重新激活通常会产生带状疱疹（带状疱疹），其特征是皮节分布疼痛和皮疹。带状疱疹通常伴有慢性疼痛（带状疱疹后神经痛或 PHN）以及脑膜炎或脑膜脑炎、小脑炎、孤立性颅神经麻痹导致眼肌麻痹或 Ramsay Hunt 综合征、多发性颅神经麻痹（颅神经炎）、血管病、脊髓病和眼部各种炎症性疾病。重要的是，VZV 重新激活可导致无皮疹的慢性神经根痛（疱疹后无疹），以及上述所有无皮疹的神经病变。VZV 在无皮疹的情况下引起的多变的神经和眼部疾病对临床医生来说是一个挑战。这些病症的表现从急性到亚急性到慢性不等。病毒学确认需要在脑脊液（CSF）或血液单核细胞中证明可扩增的 VZV DNA，或在 CSF 中存在抗 VZV IgG 抗体，或在 CSF 或血清中存在抗 VZV IgM 抗体。
