Varicella zoster presenting as cranial polyneuropathy
Itamar Niesvizky-Kogan1, Indrit Greca2, Harvir Singh Gambhir2
1Department of Medicine, SUNY Upstate Medical University, United States of America.
The American Journal of Emergency Medicine
|December 26, 2018
Summary
Varicella zoster virus (VZV) can cause cranial polyneuropathy, leading to symptoms like dysphagia and facial weakness. Emergency departments should consider VZV infection in patients with multiple cranial nerve palsies, even without a rash.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Cranial polyneuropathy, often linked to Lyme disease, presents diagnostic challenges.
- Symptoms include dysphagia, dysphonia, and facial weakness due to cranial nerve deficits.
Observation:
- A case study involved a patient with unexplained cranial nerve palsies.
- Initial workup excluded Lyme disease and vascular etiologies.
- Cerebrospinal fluid analysis identified varicella zoster virus (VZV).
Findings:
- Varicella zoster virus (VZV) infection is a rare but recognized cause of cranial polyneuropathy.
- This diagnosis was confirmed through cerebrospinal fluid analysis.
- Multiple cranial nerve palsies can occur in VZV infections.
Implications:
- Clinicians should consider VZV infection in patients presenting with multiple cranial nerve palsies.
- Diagnostic suspicion for VZV is crucial, even in the absence of a characteristic rash.
- Early identification and treatment of VZV can prevent further neurological complications.
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