A case of Vernet syndrome with varicella zoster virus infection.
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.
Kawabe
Kiyokazu
K
Department of Neurology, Toho University Medical Center Omori Hospital, 6-11-1 Omori-nishi Ohta-ku, Tokyo, Japan. kawabekiyokazu@med.toho-u.ac.jp
Sekine
Tokinori
T
Murata
Kiyoko
K
Sato
Ryuta
R
Aoyagi
Joe
J
Kawase
Yuji
Y
Ogura
Naoko
N
Kiyozuka
Tetuhito
T
Igarashi
Osamu
O
Iguchi
Hiroaki
H
Fujioka
Toshiki
T
Iwasaki
Yasuo
Y
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
D000906:Antibodies