Acute truncal ataxia in a healthy adult with varicella zoster virus cerebellitis: A case report and literature review.

Authors:
Nicholas L Zalewski
Nicholas L Zalewski
Mayo Clinic
Rochester | United States

J Neurol Sci 2019 May 2;400:186-187. Epub 2019 Apr 2.

Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.

Acute cerebellitis is a well recognized complication of varicella zoster virus (VZV) infection in children. It has been described in adults in the setting of virus reactivation with a preceding herpes zoster rash, but it is exceedingly rare in adults who are not elderly or immunocompromised, particularly in the absence of a rash. To our knowledge, there has been only one reported case of acute cerebellitis in an immunocompetent adult less than age 65 with virological confirmation of acute VZV infection. We describe a 59-year-old immunocompetent man who presented with acute truncal ataxia without rash and was diagnosed with VZV cerebellitis, supported by anti-VZV IgM and anti-VZV IgG antibodies in the serum and a positive VZV polymerase chain reaction in cerebrospinal fluid. He had robust improvement with intravenous acyclovir treatment and was free of neurologic disability at two month follow-up. This case highlights the importance of virological evaluation in patients with acute ataxia, even in the absence of typical features of infection.

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http://dx.doi.org/10.1016/j.jns.2019.04.001DOI Listing
May 2019
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