Hoshino Masashi, Itoh Aoi, Shimizu Takahiro, Akiyama Hisanao, Yamano Yoshihisa
Department of Internal Medicine, Division of Neurology, St. Marianna University School of Medicine.
Brain Nerve. 2023 Mar;75(3):269-273. doi: 10.11477/mf.1416202319.
We present the case of a 62-year-old woman who was receiving treatment for herpes zoster and experienced paraplegia, and bladder and bowel disturbance. The brain MRI diffusion-weighted image showed an abnormal hyperintense signal and apparent diffusion coefficient decreased in left medulla oblongata. The spinal cord MRI T2-weighted image showed abnormal hyperintense lesions in the left side of cervical spinal cord and thoracic spinal cord. We diagnosed varicella-zoster myelitis with medullary infarction, because varicella-zoster virus DNA was detected in the cerebrospinal fluid by polymerase chain reaction. The patient recovered with early treatment. This case shows the importance of evaluating not only skin lesions, but also distant lesions. (Received 15 November, 2022; Accepted 12 Jaunuary, 2023; Published 1 March, 2023).
我们报告了一例62岁女性病例，该患者正在接受带状疱疹治疗，却出现了截瘫以及膀胱和肠道功能障碍。脑部MRI弥散加权成像显示左侧延髓有异常高信号，表观扩散系数降低。脊髓MRI T2加权成像显示颈髓和胸髓左侧有异常高信号病变。我们诊断为水痘-带状疱疹脊髓炎合并延髓梗死，因为通过聚合酶链反应在脑脊液中检测到了水痘-带状疱疹病毒DNA。患者经早期治疗后康复。该病例表明不仅要评估皮肤病变，还要评估远处病变的重要性。（2022年11月15日收稿；2023年1月12日接受；2023年3月1日发表）
