Chickenpox: Just one way to catch a neurological issue

[Guest guest]

We have seen reports from families who have seemed to have lost their child

after the

chicken pox vaccine. We have also seen reports of " pox " like break outs during

antiviral

therapy.

Binstock passed this around this morning. It talks about chicken pox

virus caught

in the nervous system, causing brain inflammation and not showing up on the skin

at all.

- Stan

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J Neurol Neurosurg Psychiatry. 2006 Aug;77(8):938-42. Epub 2006 Apr 25.

Related Articles, Links

Polymerase chain reaction analysis and oligoclonal antibody in the cerebrospinal

fluid

from 34 patients with varicella-zoster virus infection of the nervous system.

Gregoire SM, van Pesch V, Goffette S, Peeters A, Sindic CJ.

Department of Neurology, Université catholique de Louvain, Cliniques

Universitaires Saint-

Luc, Brussels, Belgium.

OBJECTIVE: To study cerebrospinal fluid (CSF) and serum samples from 34

consecutive

patients suspected of having varicella-zoster virus (VZV) infection of the

central nervous

system (CNS). Population and METHODS: The patients were divided into three

groups. The

first group consisted of 27 patients with a rash in one to three dermatomes and

clinical

suspicion of meningitis and radiculitis; among them, three subgroups were

distinguished

according to the affected dermatome: ophthalmicus (n = 9), oticus (n = 11) and

cervico-

thoraco-lumbar zoster (n = 7). Four cases of zoster sine herpete (ZSH) were

included in

the second group: these patients presented with either radiculitis (n = 2) or

meningoencephalitis (n = 2), without cutaneous eruption. The third group

consisted of

three patients with a generalised rash and encephalitis. A polymerase chain

reaction (PCR)

for VZV DNA and antigen-driven immunoblots for oligoclonal anti-VZV antibodies

were

carried out on all CSF samples. RESULTS: PCR of the CSF was positive in 44% of

the

patients from the first group, mainly within the first 7 days after eruption. In

addition,

intrathecal synthesis of anti-VZV antibodies was detected in 37% of patients,

always after

an interval of 7 days (p<0.0001). Among the four patients with ZSH, a positive

VZV PCR

was detected in three patients and CSF-specific oligoclonal anti-VZV antibodies

in two.

PCR was also positive in the CSF of two of the three patients with generalised

rash and

encephalitis; local production of anti-VZV antibodies was seen in a second CSF

sample in

one patient, and was also present in the third patient. CONCLUSION:

Amplification of VZV

DNA by PCR in the CSF and antigen-driven immunoblots have important diagnostic

value

in suspected VZV infection, although their presence depends on the timing of the

CSF

sampling. VZV is thought to be a causative agent in unexplained cases of

meningitis

associated with radiculitis or focal CNS symptoms, even in the absence of skin

manifestations. In such patients, rapid diagnosis by this combined approach

permits early

antiviral treatment.