title: Acute, chronic, and recurrent varicella zoster virus neuropathy without zoster rash.
abstract: The authors report three patients with acute, chronic, and recurrent neuropathy associated with varicella zoster virus (VZV) infection but without zoster rash. CSF of all three patients contained VZV immunoglobulin G antibody, but not herpes simplex virus. In two patients, serum/CSF ratios of VZV immunoglobulin G were reduced compared to normal ratios for immunoglobulin G and albumin, and one patient also had VZV immunoglobulin M in CSF. All three patients received antiviral therapy and improved. The diagnosis of nervous system infection by VZV may be confirmed by the presence of antibody to VZV in CSF even without detectable VZV DNA.
authors.affiliation: Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Fox
authors.forename: S L
authors.initials: SL
authors.lastname: Galetta
authors.forename: R
authors.initials: R
authors.lastname: Mahalingam
authors.forename: M
authors.initials: M
authors.lastname: Wellish
authors.forename: B
authors.initials: B
authors.lastname: Forghani
authors.forename: D H
authors.initials: DH
authors.lastname: Gilden
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002490:Central Nervous System / Q000473:pathology*; D002493:Central Nervous System Diseases / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006562:Herpes Zoster / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence