title: A case of Vernet syndrome with varicella zoster virus infection.
abstract: A 40-year-old man was admitted to our department, because of sudden onset of dysphagia, hoarseness, left neck pain and headache. There were no skin lesions. On neurological examination, there were paralysis of the left soft palate and constrictor muscles of the pharynx, weakness of the left sternocleidomastoid and left upper trapezius. In cerebrospinal fluid (CSF) examination, cell count and protein concentration were elevated. Antibody titer to varicella zoster virus (VZV) was elevated in both the serum and CSF. And VZV-DNA was detected by PCR from CSF. Gd enhanced MRI showed the nodular lesion at the left jugular foramen. The diagnosis of Vernet's syndrome (VS) associated with VZV infection was made. The patient's symptoms were immediately improved with 30 mg of prednisone and 3 g of varaciclovir daily for 14 days. Only a few cases of VS due to VZV have been reported previously. Our case is the first case that detected VZV-DNA in CSF by PCR.
authors.affiliation: Department of Neurology, Toho University Medical Center Omori Hospital, 6-11-1 Omori-nishi Ohta-ku, Tokyo, Japan. kawabekiyokazu@med.toho-u.ac.jp
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Kawabe
authors.forename: Tokinori
authors.initials: T
authors.lastname: Sekine
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Murata
authors.forename: Ryuta
authors.initials: R
authors.lastname: Sato
authors.forename: Joe
authors.initials: J
authors.lastname: Aoyagi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kawase
authors.forename: Naoko
authors.initials: N
authors.lastname: Ogura
authors.forename: Tetuhito
authors.initials: T
authors.lastname: Kiyozuka
authors.forename: Osamu
authors.initials: O
authors.lastname: Igarashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Iguchi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Fujioka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Iwasaki
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood / Q000134:cerebrospinal fluid; D020804:Encephalitis, Varicella Zoster / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D020435:Glossopharyngeal Nerve Diseases / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020421:Vagus Nerve Diseases / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000821:virology
chemical_list: D000906:Antibodies