Encephalitis and Motor Paresis Caused by Herpes Zoster -A case report-

Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.