Varicella-zoster virus infection and autonomic dysfunction
Ryuji Sakakibara1, Setsu Sawai1, Tsuyoshi Ogata1
1Department of Neurology, Sakura Medical Center, Toho University, Sakura, Japan.
Autonomic Neuroscience : Basic & Clinical
|July 21, 2022
Summary
Varicella-zoster virus (VZV) infection can cause autonomic dysfunction, particularly affecting the bladder and bowel. Early recognition and collaboration are key for managing VZV-related autonomic issues.
Area of Science:
- Neurology
- Infectious Diseases
- Autonomic Nervous System
Background:
- Autonomic dysfunction is an infrequent complication of varicella-zoster virus (VZV) infection.
- Systematic reviews on VZV-induced autonomic dysfunction are scarce.
Purpose of the Study:
- To systematically review and summarize autonomic dysfunction resulting from VZV infection.
Main Methods:
- Adherence to PRISMA guidelines.
- Systematic search of three databases for English-language, full-length cross-sectional studies.
- Utilized specific search keywords for VZV and autonomic dysfunction.
Main Results:
- Reviewed 45 studies from an initial 102 identified articles.
- VZV infection can manifest as pupillomotor, sudomotor, cardiovascular, gastrointestinal, and urogenital dysfunction.
- VZV rarely causes orthostatic hypotension (diffuse sympathetic dysfunction) but frequently leads to bladder and bowel dysfunction (segmental parasympathetic/sympathetic dysfunction via dorsal root ganglionopathy).
Conclusions:
- VZV-related autonomic dysfunction, especially gastrointestinal and urogenital, requires clinical awareness.
- Patients may initially present to gastroenterology or urology clinics.
- Multidisciplinary collaboration (neurology, dermatology, gastroenterology, urology) is crucial for early antiviral treatment and comprehensive bowel/bladder management.
Keywords:
Autonomic dysfunctionDorsal root gangliaIntestinal pseudo-obstructionUrinary retentionVaricella-zoster virusMore Related Videos
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