Korean J Pain.  2005 Jun;18(1):85-88. 10.3344/kjp.2005.18.1.85.

Encephalitis and Motor Paresis Caused by Herpes Zoster: A case report

• Heo HM
• Lee KC
• Yang HD
• Lee SI

• KMID: 2277967
• DOI: http://doi.org/10.3344/kjp.2005.18.1.85

Abstract

Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.

Keyword

herpetic motor paresis; stellate ganglion block; varicella-zoster encephalitis

MeSH Terms

Acyclovir
Administration, Intravenous
Brain
Central Nervous System
Cerebrospinal Fluid
Diagnosis
Early Diagnosis
Encephalitis*
Female
Fever
Headache
Herpes Zoster*
Herpesvirus 3, Human
Humans
Immunity, Cellular
Immunoglobulin G
Incidence
Magnetic Resonance Imaging
Paresis*
Scalp
Seizures
Shoulder Pain
Skin
Stellate Ganglion
Acyclovir
Immunoglobulin G