Tecellioglu Mehmet, Kamisli Suat, Erbay Mehmet Fatih, Kamisli Ozden, Ozcan Cemal
Inonu university, Turgut Ozal medicine center, Neurology department, Malatya, Turkey.
Inonu university, Turgut Ozal medicine center, Radiology department, Malatya, Turkey.
Med Arch. 2017 Aug;71(4):293-295. doi: 10.5455/medarh.2017.71.293-295.
Varicella Zoster Virus (VZV) is associated with many disorders of the central and peripheral nervous systems including neuralgia, meningitis, meningoencephalitis, cerebellitis, vasculopathy, myelopathy, Ramsay-Hunt syndrome, and polyneuritis cranialis. Cranial nerves V, VI, VII, VIII, IX, X, XI, and/or XII may be affected. The neurological disorders caused by VZV usually present with rash, but may rarely present without rash.
We herein present a case of polyneuritis cranialis without rash caused by VZV affecting cranial nerves VII, VIII, IX, and X. After excluding other causes of the condition, we diagnosed VZV infection based on VZV DNA in the CSF and an elevated anti-VZV IgG level in serum. The patient responded well to antiviral therapy.
VZV infection should be kept in mind during the differential diagnosis of polyneuritis cranialis; it is important to note that VZV re-activation may occur without rash.
水痘带状疱疹病毒（VZV）与许多中枢和周围神经系统疾病相关，包括神经痛、脑膜炎、脑膜脑炎、小脑炎、血管病变、脊髓病、拉姆齐-亨特综合征和颅神经炎。颅神经V、VI、VII、VIII、IX、X、XI和/或XII可能会受到影响。由VZV引起的神经系统疾病通常伴有皮疹，但很少在无皮疹的情况下出现。
我们在此报告一例由VZV引起的无皮疹颅神经炎病例，该病例影响颅神经VII、VIII、IX和X。在排除该病症的其他病因后，我们根据脑脊液中的VZV DNA和血清中抗VZV IgG水平升高诊断为VZV感染。患者对抗病毒治疗反应良好。
在颅神经炎的鉴别诊断过程中应考虑VZV感染；需要注意的是，VZV再激活可能在无皮疹的情况下发生。
