Buonsenso Danilo, Focarelli Benedetta, Valentini Piero, Onesimo Roberta
Department of Pediatrics, Pediatric Infectious Diseases Unit, Catholic University of the Sacred Heart, Rome, Italy.
BMJ Case Rep. 2012 Jul 19;2012:bcr2012006362. doi: 10.1136/bcr-2012-006362.
Acute inflammatory polyneuropathy is an inflammatory demyelinating disease triggered by an autoimmune mechanism. It follows an infection or an immunisation after a free interval of 2-30 days. We report a case of a 14-year-old boy who develops an acute rapidly progressive paraplegia, urine incontinence and positive Lasegue a week after a characteristic chickenpox rash. Spinal MRI showed diffuse thickening and leptomeningeal enhancement of cauda equina nerve roots. Intravenous immunoglobulins were given and yielded a dramatic clinical and radiological improvement. The patient was discharged without any clinical problems 1 month after the onset of symptoms. We performed a review of the literature, discussing the different forms of varicella-zoster virus-related central and peripheral nervous system complications and management strategies for acute postinfectious encephalomyelitis/radiculitis.
急性炎性多发性神经病是一种由自身免疫机制引发的炎性脱髓鞘疾病。它在感染或免疫接种后经过2至30天的无病症间隔期后出现。我们报告一例14岁男孩，在出现典型水痘皮疹一周后，出现急性快速进展性截瘫、尿失禁及拉塞格征阳性。脊髓磁共振成像显示马尾神经根弥漫性增粗及软脊膜强化。给予静脉注射免疫球蛋白后，临床及影像学表现显著改善。症状出现1个月后，患者无任何临床问题出院。我们对文献进行了综述，讨论了水痘-带状疱疹病毒相关的中枢和周围神经系统并发症的不同形式以及急性感染后脑脊髓炎/神经根炎的管理策略。
