Cerebral vasculitis and obsessive-compulsive disorder following varicella infection in childhood

Area of Science:

• Neurology
• Infectious Diseases
• Pediatrics

Background:

• Varicella (chickenpox) is a common childhood viral illness, typically self-limiting.
• While generally benign, varicella can lead to severe complications, particularly in immunocompromised individuals or adults.
• Neurological complications of varicella, though infrequent, can be life-threatening.

Observation:

• A previously healthy eight-year-old boy developed acute hemiplegia and obsessive-compulsive disorder (OCD).
• These symptoms were linked to a lesion in the lentiform nuclei.
• The onset followed a recent varicella infection.

Findings:

• The case demonstrates a rare neurological sequela of varicella infection in a pediatric patient.
• The patient presented with both motor deficits (hemiplegia) and psychiatric symptoms (OCD).
• Magnetic resonance imaging revealed a lesion in the lentiform nuclei correlating with the neurological presentation.

Implications:

• This case highlights the potential for severe neurological manifestations of varicella beyond typical childhood illness.
• Early recognition and targeted treatment are crucial for managing these rare but significant complications.
• The successful treatment with sertraline for OCD symptoms suggests effective management strategies are available.