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A case of herpes zoster myelitis: positive magnetic resonance imaging finding
Y M Hwang1, B I Lee, J W Chung
1Department of Neurology, Asan Medical Center, Ulsan University, Seoul, Korea.
Abstract:
A 33-year-old man developed a progressive myelopathy after a characteristic skin lesion of herpes zoster involving the right C3 and C4 dermatomes. The lesions were recognizable in the T2-weighted image of the magnetic resonance imaging (MRI) as increased signal intensities throughout the long segments of the spinal cord with maximal in the cervical portion, which was compatible with the pathological findings reported in autopsy studies.
Insights
Herpes zoster can cause progressive myelopathy, a spinal cord disease. MRI revealed spinal cord lesions consistent with autopsy findings in a patient with a C3-C4 dermatome rash.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Herpes zoster, commonly known as shingles, is caused by the varicella-zoster virus reactivation.
- Myelopathy refers to damage or disease of the spinal cord.
Observation:
- A 33-year-old male presented with progressive myelopathy.
- The patient had a characteristic skin rash of herpes zoster affecting the C3 and C4 dermatomes.
Findings:
- Magnetic resonance imaging (MRI) demonstrated T2-weighted hyperintensities in extensive spinal cord segments.
- Lesion intensity was maximal in the cervical spinal cord.
- These MRI findings correlated with known pathological autopsy data for myelopathy.
Implications:
- This case highlights a potential neurological complication of herpes zoster affecting the spinal cord.
- Early recognition and diagnosis of herpes zoster-related myelopathy are crucial for patient management.
- Spinal MRI is a valuable tool for diagnosing myelopathy secondary to viral infections.