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Atypical anti-NMDA receptor encephalitis associated with varicella zoster virus infection.
Fatma, Nabli; Zakaria, Saied; Mourad, Zouari; Samir, Belal; Samia, Ben Sassi.
Afiliación
  • Fatma N; Neurology Department, Mongi Ben Hamida Institute of Neurology, University of Tunis El Manar, Omar Chedly Street 1029, Bab Saâdoun, Tunis, Tunisia.
  • Zakaria S; Neurology Department, Mongi Ben Hamida Institute of Neurology, University of Tunis El Manar, Omar Chedly Street 1029, Bab Saâdoun, Tunis, Tunisia. zakariasaied@hotmail.com.
  • Mourad Z; Neurology Department, Mongi Ben Hamida Institute of Neurology, University of Tunis El Manar, Omar Chedly Street 1029, Bab Saâdoun, Tunis, Tunisia.
  • Samir B; Neurology Department, Mongi Ben Hamida Institute of Neurology, University of Tunis El Manar, Omar Chedly Street 1029, Bab Saâdoun, Tunis, Tunisia.
  • Samia BS; Neurology Department, Mongi Ben Hamida Institute of Neurology, University of Tunis El Manar, Omar Chedly Street 1029, Bab Saâdoun, Tunis, Tunisia.
J Neurovirol ; 28(3): 456-459, 2022 06.
Article en En | MEDLINE | ID: mdl-35604574
The triggering effect of herpes simplex virus infection on the development of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is now well established. However, there are very few reports that has linked a varicella zoster virus (VZV) reactivation with anti-NMDAR encephalitis. In this report, we describe a case of a 57-year-old man presented with atypical clinical presentation of anti-NMDAR encephalitis with gait ataxia, complete ophtalmoplegia, and abolished reflexes followed by drowsiness and confusion. Initial diagnosis of Bickerstaff's brainstem encephalitis was suspected. Few days later, the patient developed herpes zoster in a localized right T1-T2 dermatome. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for VZV was negative. CSF anti-NMDA antibodies were proved positive. A diagnosis of anti-NMDAR encephalitis with concomitant VZV skin reactivation was retained. Favorable outcome with combined antiviral treatment and immunomodulatory therapy was observed. Concomitant VZV reactivation with autoimmune encephalitis is possible. Prognosis and therapeutic options in this rare condition remain to be clarified.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Varicela / Encefalitis Antirreceptor N-Metil-D-Aspartato / Infección por el Virus de la Varicela-Zóster / Herpes Zóster Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Neurovirol Asunto de la revista: NEUROLOGIA / VIROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Túnez Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Varicela / Encefalitis Antirreceptor N-Metil-D-Aspartato / Infección por el Virus de la Varicela-Zóster / Herpes Zóster Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Neurovirol Asunto de la revista: NEUROLOGIA / VIROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Túnez Pais de publicación: Estados Unidos