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Varicella-zoster virus (VZV) myelitis is a rare but serious complication of VZV reactivation that can lead to significant neurological deficits. While antiviral therapy is the mainstay of treatment, the role of corticosteroids remains unclear. We present a case of a 30-year-old male who developed progressive asymmetric lower-extremity weakness, constipation, and urinary retention without a dermatomal rash in the setting of HIV/AIDS. MRI revealed longitudinally extensive transverse myelitis, and cerebrospinal fluid (CSF) analysis confirmed VZV reactivation. The patient was treated with ganciclovir and high-dose corticosteroids, leading to an initial neurological improvement. This case highlights the potential benefit of adjunctive corticosteroid therapy in reducing inflammation and improving outcomes in VZV myelitis. Given the lack of standardized treatment guidelines, further studies are needed to clarify the role of corticosteroids and optimize management strategies for this condition.
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http://dx.doi.org/10.7759/cureus.83689 | DOI Listing |
Ann Med Surg (Lond)
September 2025
Department of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Introduction And Importance: Zoster-induced Guillain-Barré syndrome (ZGBS) is a rare neurological complication of varicella-zoster virus (VZV) reactivation. Diagnosing ZGBS is challenging due to its overlapping clinical features with other forms of Guillain-Barré syndrome (GBS) and zoster myelitis. This report emphasizes the importance of early recognition and tailored treatment, particularly in resource-limited settings.
View Article and Find Full Text PDFIDCases
July 2025
Department of Neurology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction: Acute transverse myelitis (ATM) is a rare inflammatory disorder that affects the spinal cord, leading to sudden weakness, sensory deficits, and bowel/bladder dysfunction. Also rare, this condition can be caused by infections such as the Varicella-zoster virus (VZV) or can occur as a complication of systemic lupus erythematosus (SLE). It has been reported to be more prevalent in SLE patients compared to VZV infections.
View Article and Find Full Text PDFCureus
May 2025
Pharmacotherapeutics and Clinical Research, University of South Florida Taneja College of Pharmacy, Tampa, USA.
Varicella-zoster virus (VZV) myelitis is a rare but serious complication of VZV reactivation that can lead to significant neurological deficits. While antiviral therapy is the mainstay of treatment, the role of corticosteroids remains unclear. We present a case of a 30-year-old male who developed progressive asymmetric lower-extremity weakness, constipation, and urinary retention without a dermatomal rash in the setting of HIV/AIDS.
View Article and Find Full Text PDFCureus
April 2025
Neurology, Yokkaichi Municipal Hospital, Yokkaichi, JPN.
Identifying the cause of myelopathy is difficult because associated clinical and imaging findings are nonspecific. The onset pattern and magnetic resonance imaging (MRI) findings are important for the diagnosis. Herein, we present the case of a 70-year-old woman hospitalized with acute-onset weakness of the lower limbs.
View Article and Find Full Text PDFFront Neurol
February 2025
Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Background: Varicella-zoster virus (VZV) central nervous system infection is typically observed in immunocompromised patients, and there is a lack of studies involving large samples of non-immunocompromised individuals. In this study, we retrospectively analyzed 108 non-immunocompromised patients diagnosed with VZV central nervous system infection.
Methods: This retrospective study was conducted in the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, China.