Department of Neurology, University Hospital of Bogodogo, Ouagadougou, Burkina Faso.
Department of Neurology, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso.
BMC Neurol. 2023 Mar 30;23(1):133. doi: 10.1186/s12883-023-03185-8.
Polyradiculoneuropathy following infection with varicella zoster virus (VZV) is rare and most of the time, happens in the context of reactivation of latent VZV. We report a case of acute polyradiculoneuropathy following primary infection with VZV marked by atypical clinical features raising the hypothesis of a para-infectious disease.
We describe a 43-years-old male who developed ataxia, dysphagia, dysphonia, and oculomotor disorders (vertical binocular diplopia and bilateral ptosis) followed by quadriplegia with areflexia which occurred 4 days later. The patient had a history of varicella that occurred 10 days before the onset of these symptoms. Nerve conduction study revealed features consistent with an acute motor-sensory axonal neuropathy (AMSAN). Anti-ganglioside antibodies were negative. Based on clinical presentation and ancillary examination, we retain the Miller Fisher/Guillain-Barré overlap syndrome diagnosis. The patient was treated with high doses of methylprednisolone but the evolution of the disease was nevertheless marked by a complete recovery six weeks after onset of symptoms.
GBS following varicella is a rare but severe disease occurring most often in adults and marked by greater involvement of the cranial nerves. Its clinical features suggest that it is a para-infectious disease. Antiviral therapy has no effect on the course of the disease but its administration within the first 24 h after the onset of chickenpox in adults can prevent its occurrence.
水痘带状疱疹病毒（VZV）感染后引起的多发性神经根炎很少见，大多数情况下是在潜伏的 VZV 重新激活的情况下发生的。我们报告了一例 VZV 原发性感染后急性多发性神经根炎的病例，其临床特征不典型，提示为一种类感染性疾病。
我们描述了一例 43 岁男性患者，他在出现这些症状的 4 天前出现了水痘，随后出现了共济失调、吞咽困难、发音困难和眼动障碍（垂直双眼复视和双侧上睑下垂），接着出现了四肢瘫痪和反射消失。神经传导研究显示符合急性运动感觉轴索性神经病（AMSAN）的特征。抗神经节苷脂抗体阴性。根据临床表现和辅助检查，我们保留了米勒-费舍尔/格林-巴利重叠综合征的诊断。患者接受了大剂量甲基强的松龙治疗，但疾病的演变仍然是在症状出现后 6 周完全恢复。
水痘后发生的吉兰-巴雷综合征是一种罕见但严重的疾病，最常发生在成年人，且更常累及颅神经。其临床特征提示为一种类感染性疾病。抗病毒治疗对疾病的病程没有影响，但在成年人出现水痘后的 24 小时内给予抗病毒治疗可以预防其发生。
