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Neurology 2001;57:351-354
© 2001 American Academy of Neurology
Brief Communications

Acute, chronic, and recurrent varicella zoster virus neuropathy without zoster rash

R.J. Fox, MD;, S.L. Galetta, MD;, R. Mahalingam, PhD;, M. Wellish, BS;, B. Forghani, PhD; and D.H. Gilden, MD

From the Department of Neurology (Drs. Fox and Galetta), University of Pennsylvania School of Medicine, Philadelphia; Viral and Rickettsial Disease Branch (Dr. Forghani), California State Department of Health Services, Berkeley; and the Departments of Neurology (Drs. Gilden and Mahalingam, and M. Wellish) and Microbiology (Dr. Gilden), University of Colorado Health Sciences Center, Denver.

Address correspondence and reprint requests to Dr. Donald H. Gilden, Department of Neurology, Mailstop B182, University of Colorado Health Sciences Center, 4200 East 9th Avenue, Denver, CO 80262; e-mail: don.gilden{at}uchsc.edu

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.




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