Varicella zoster virus reactivation antedating ipsilateral brainstem stroke
Giuliana Galassi1, Maurilio Genovese, Marisa Meacci
1Department of Biomedical, Metabolic, Neural Sciences, University Hospital of Modena.
Dermatology Online Journal
|January 26, 2019
Summary
Varicella zoster virus (VZV) reactivation can precede ipsilateral brainstem stroke, even in immunocompetent individuals. Early diagnosis and treatment with acyclovir are crucial for recovery.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Varicella zoster virus (VZV) reactivation is linked to various neurological conditions.
- Cranial nerve zoster can lead to vascular complications through viral spread and inflammation.
Observation:
- Two immunocompetent patients experienced VZV reactivation followed by ipsilateral brainstem stroke.
- Symptoms included cranial nerve deficits, weakness, and sensory disturbances.
- Neuroimaging revealed pontine infarction and retrobulbar tissue alterations.
Findings:
- Both patients had VZV IgG and IgM antibodies.
- Cerebrospinal fluid analysis showed lymphocytic pleocytosis and elevated protein.
- Intravenous acyclovir treatment led to clinical improvement.
Implications:
- This case series highlights an unusual but significant association between VZV reactivation and brainstem stroke.
- It underscores the importance of considering VZV as a potential cause of stroke in affected patients.
- Prompt antiviral therapy may improve outcomes in these rare neurological presentations.
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