J Korean Neurol Assoc.  1996 Mar;14(1):298-301.

Syndrome of Inappropriate Secretion of Antidiuretie Hormone (SIADH) Associated with Herpes Zoster Ophhtalmicus

• Han MK
• Lee JG
• Han HJ
• Lee KH
• Han SH
• Lee SS

Abstract

A case of syndrome of inappropriate secretion of antidiuretic hormome (SIADH) associated with herpes zoster ophthalmicus is reported. A 77-year-old man was admitted for treatment of left facial pain and vesicular lesions during 7 days. On admission, physical examination revealed vesicular eruptions on the left face and on neurologic examination, he revealed an alert, well-oriented mentality. Neither sensory disturbance nor nuchal rigidity was noted. Further investigation revealed hyponatremia 115mEq/L, low serum osmolality, high urine osmolarity, high urinary sodium secretion, normal renal function, normal adrenal and thyroid function. Cerebrospinal examination revealed a pleocytosis, mild protein elevation, normal glucose. No malignant cells were present and microorganism examinations were negative. Only water restriciton was started. But he revealed confusional mentality and aggravation of hyponatremia(110m2q/L). Intravenous hypertonic saline also was started, and the patient's sensorium was improved in accordance with the increase in serum sodium concentration. In the absence of other recognized causes we suggest that the two conditions(SIADH and Herpes Zoster Infection) may have related and speculate on possible mechanisms. In this report, we postulate that the hyponatremia was due to SIADH and that SIADH was caused by the infection of varicella-zoster virus(VZV) in central nervous system.

MeSH Terms

Aged
Central Nervous System
Facial Pain
Glucose
Herpes Zoster Ophthalmicus
Herpes Zoster*
Humans
Hyponatremia
Inappropriate ADH Syndrome
Leukocytosis
Muscle Rigidity
Neurologic Examination
Osmolar Concentration
Physical Examination
Sodium
Thyroid Gland
Water
Glucose
Sodium
Water