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Zoster sine herpete, a clinical variant
D H Gilden1, R R Wright, S A Schneck
1University of Colorado School of Medicine, Department of Neurology, Denver 80262.
Annals of Neurology
|May 1, 1994
Summary
Zoster sine herpete is a clinical variant causing prolonged radicular pain without a rash. Varicella-zoster virus DNA in cerebrospinal fluid confirmed this diagnosis in two immunocompetent men.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Radicular pain can significantly impact quality of life.
- Zoster sine herpete is a rare manifestation of varicella-zoster virus infection.
- Distinguishing zoster sine herpete from other causes of radicular pain can be challenging.
Observation:
- Two immunocompetent men, aged 62 and 66, presented with years of radicular pain.
- Extensive medical evaluations ruled out systemic diseases and malignancy.
- Varicella-zoster virus (VZV) DNA was detected in the cerebrospinal fluid of both patients.
Findings:
- The presence of VZV DNA in cerebrospinal fluid, in the absence of a zoster rash, confirmed the diagnosis of zoster sine herpete.
- This diagnosis was made months after the initial onset of radicular pain in both individuals.
Implications:
- These findings support zoster sine herpete as a distinct clinical variant of varicella-zoster virus infection.
- Recognizing ZSH is crucial for accurate diagnosis and management of patients with unexplained radicular pain.
- Further research into VZV neurological complications is warranted.