Bulbar encephalitis complicating trigeminal zoster in the acquired immune deficiency syndrome.
A 30-year-old homosexual man with the acquired immune deficiency syndrome and a recent history of zoster involving the mandibular division of the right trigeminal nerve was found at autopsy to have a predominantly demyelinating lesion restricted to the ipsilateral spinal trigeminal tract and nucleus. Cowdry A inclusions were readily apparent in the nuclei of numerous glia and isolated neurons, and inclusion-bearing cells were immunoreactive with an antiserum to the varicella zoster virus (VZV). This represents the first demonstration that zoster-associated trigeminal encephalitis is the result of brainstem invasion by VZV. The restricted topography of this lesion implicates axonal transport in its pathogenesis.
Rosenblum
M K
MK
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001933:Brain Stem / Q000473:pathology; D003389:Cranial Nerve Diseases / Q000150:complications*; D004660:Encephalitis / Q000150:complications*; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D008297:Male; D013116:Spinal Cord / Q000473:pathology; D014276:Trigeminal Nerve