Department of Neurology, Sakura Medical Center, Toho University, Sakura, Japan.
Department of Neurology, Sakura Medical Center, Toho University, Sakura, Japan.
Auton Neurosci. 2022 Nov;242:103018. doi: 10.1016/j.autneu.2022.103018. Epub 2022 Jul 8.
Autonomic dysfunction has been occasionally described in varicella-zoster virus (VZV) infection, while few systematic reviews are available. We systematically review autonomic dysfunction due to VZV infection.
This study followed the PRISMA guideline, and three databases were researched and included cross-sectional studies in full-length publications in the English language using appropriate search keywords.
A total of 102 articles were identified initially; finally 45 studies were used for review, comprising pupillomotor dysfunction in 4, sudomotor dysfunction in 2, cardiovascular dysfunction in 2, gastrointestinal dysfunction in 14, and urogenital dysfunction in 23. They can be summarized as (1) VZV infection rarely produces orthostatic hypotension, which involves diffuse sympathetic dysfunction by polyneuropathy. (2) In contrast, VZV infection produces dysfunction of the bladder and the bowel, which involves segmental parasympathetic or sympathetic dysfunction by dorsal root ganglionopathy.
Awareness of VZV-related autonomic dysfunction is important, because such patients may first visit a gastroenterology or urology clinic. Close collaboration among neurologists, dermatologists, gastroenterologists, and urologists is important to start early antiviral agents and maximize bowel and bladder care in such patients.
水痘带状疱疹病毒（VZV）感染偶尔会出现自主神经功能障碍，但目前可用的系统评价较少。我们系统地综述了 VZV 感染导致的自主神经功能障碍。
本研究遵循 PRISMA 指南，检索了三个数据库，并纳入了使用适当搜索关键词的全英文同行评审期刊文章的横断面研究。
最初共确定了 102 篇文章；最终有 45 项研究用于综述，其中瞳孔运动功能障碍 4 项，出汗功能障碍 2 项，心血管功能障碍 2 项，胃肠道功能障碍 14 项，泌尿生殖功能障碍 23 项。可总结为：（1）VZV 感染很少引起直立性低血压，这涉及到多神经病引起的弥漫性交感神经功能障碍。（2）相比之下，VZV 感染引起膀胱和肠道功能障碍，这涉及到背根神经节病变引起的节段性副交感神经或交感神经功能障碍。
认识 VZV 相关的自主神经功能障碍很重要，因为此类患者可能首先会到胃肠病学或泌尿科就诊。神经科医生、皮肤科医生、胃肠病学家和泌尿科医生之间的密切合作对于此类患者早期使用抗病毒药物和最大限度地进行肠道和膀胱护理非常重要。
