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Changes of the central nervous system in herpes zoster
Abstract:
Postmortem examination was conducted in eight cases of neurocutaneous herpes zoster. One generalized case with diffuse and focal meningoencephalomyelitis showed numerous infiltrates in the subarachnoid space and along the cerebral ventricles. Intranuclear inclusion bodies could be demonstrated for the first time in ependymal and in arachnoidal cells, and viral capsids were found in the latter. The parenchymal lesions, lying predominantly in the white matter, were characterized by inflammation, hemorrhage, axonal swellings, demyelination, and intranuclear inclusions in oligodendrocytes. In the second generalized case there was a granulomatous giant cell angiitis with intranuclear inclusions bodies in the vessel walls. Out of four cases with localized damage of the central nervous system (CNS), three showed demyelination as the main alteration. In another case there was a hitherto undescribed calcifying coagulation necrosis of a spinal ganglion.
Insights
Postmortem analysis of neurocutaneous herpes zoster revealed viral inclusion bodies in brain cells and demyelination in the central nervous system (CNS). This study details the neuropathology of herpes zoster affecting the brain and spinal cord.
Area of Science:
- Neuropathology
- Virology
- Neuroimmunology
Background:
- Neurocutaneous herpes zoster (VZV) can cause severe neurological complications.
- Understanding the precise neuropathological changes is crucial for diagnosis and treatment.
Observation:
- Postmortem examinations of eight neurocutaneous herpes zoster cases were performed.
- Generalized cases exhibited diffuse meningoencephalomyelitis with infiltrates and viral inclusions.
- Localized CNS damage included demyelination and calcifying coagulation necrosis.
Findings:
- Intranuclear inclusion bodies of VZV were identified in ependymal and arachnoidal cells for the first time.
- Viral capsids were observed in arachnoidal cells.
- Parenchymal lesions showed inflammation, hemorrhage, axonal swelling, demyelination, and inclusions in oligodendrocytes.
- Granulomatous giant cell angiitis with inclusions in vessel walls was noted in one case.
- Demyelination was the primary alteration in three localized CNS damage cases.
Implications:
- This study provides novel insights into the neuropathological manifestations of neurocutaneous herpes zoster.
- The identification of viral inclusions in specific cell types advances our understanding of VZV neuroinvasion.
- Findings may guide future diagnostic strategies and therapeutic interventions for VZV-related neurological disorders.