Elsberg Syndrome in Varicella Zoster Virus Infection

Elsberg syndrome (ES) is an acute-to-subacute onset, lumbosacral radiculitis, with or without myelitis, confined to lower spinal cord, often caused by herpes simplex virus (HSV)-2. We report a case of a 70-year-old lady with ES due to varicella zoster virus (VZV) reactivation, presenting as herpes zoster in right side L5-S2 dermatomes, with radiculitis in the respective roots and myelitis in the conus medullaris region. The diagnosis is often made by considering the clinical picture, as well as the investigations, such as magnetic resonance imaging (MRI) of the spine, cerebrospinal fluid (CSF) analysis, and electroneuromyography (ENMG), as a whole. Through this case report, we re-emphasize the fact that ES is an important differential to consider in patients presenting with acute-to-subacute onset lumbosacral radiculitis with/without myelitis, as the incidence of ES is around 10% in such cases.