[Case of incomplete brown-Séquard syndrome after thoracic herpes zoster infection].
e report an 87-year-old woman who presented with incomplete Brown-Séquard syndrome after reactivation of varicella-zoster virus (VZV). Two days after herpes zoster in the right side of the chest, she developed weakness of the right lower limb. Neurological examination revealed a spastic palsy in the right lower limb and left side loss of pain and temperature sense to T6. However, vibration and position sense was not impaired in both sides. Spinal T2-weighted MR images showed a high-intensity lesion in the right side of the spinal cord except posL terior funiculus at the level of T2. Cerebrospinal fluid analysis showed 109 leukocytes/mm3, 79 mg/dl protein, negative VZV PCR, elevated titer of anti-VZV IgM and IgG, and increase of IgG index. Although she was treated with a combination of acyclovir and steroid pulse therapy, her weakness in the right lower limb was not improved. In this case, since the posterior funiculus circulated from the posterior spinal artery was not involved, the incomplete Brown-S6quard syndrome may be caused by spinal cord infarction due to VZV vasculitis of the anterior spinal artery.
Department of Internal Medicine, Seikeikai Hospital.
Megumi
M
Bessho
Hideto
H
Nakajima
Takumi
T
Ito
Haruko
H
Kitaoka
D000369:Aged, 80 and over; D018437:Brown-Sequard Syndrome / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007238:Infarction / Q000150:complications; D013116:Spinal Cord / Q000098:blood supply; D014657:Vasculitis / Q000821:virology*