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September 1990, Vol 47, No. 9 >
Article | September 1990

Cerebral Vasculopathy Associated With Primary Varicella Infection

Jo F. V. Caekebeke, MD; A. C. Boudewyn Peters, MD; Bodvaz Vandvik, MD; Oebele F. Brouwer, MD; Henry M. de Bakker, MD
[+] Author Affiliations

Accepted for publication August 2, 1989.

Reprints not available.


Arch Neurol. 1990;47(9):1033-1035. doi:10.1001/archneur.1990.00530090115023
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• A previously healthy 5-year-old boy developed cerebral vasculopathy, presenting as two episodes of acute hemiparesis 3 and 9 months, respectively, after a primary varicella infection (chickenpox). This association has not been reported before, to our knowledge, although cerebral vasculopathy is a well-known complication of herpes zoster ophthalmicus. The diagnosis was based on the presence of oligoclonal varicella-specific IgG in the cerebrospinal fluid and angiographic findings. Clinical and angiographic follow-up, and serial thymidine kinase activity levels in the cerebrospinal fluid suggested a self-limiting course of the virus-induced vasculopathy. Varicella zoster virus seems to be another potential causative agent to be considered in acute childhood hemiplegia.

REFERENCES

1 +
Golden GS.  Cerebrovascular disease . In: Swainman KF, ed. Pediatric Neurology . St Louis, Mo: CV Mosby Co; 1989;:603-623.
2 +
Gold AP, Carter S.  Acute hemiplegia of infancy and childhood . Pediatr Clin North Am . 1976;;23:413-433.
3 +
Hilt DC, Buchholz D, Krumholz A, et al.  Herpes zoster ophthalmicus and delayed contralateral hemiparesis caused by cerebral angiitis: diagnosis and management approaches . Ann Neurol . 1983;;14:543-553.
4 +
Fukumoto S, Mitsuru K, Hokamura K, et al.  Subarachnoid hemorrhage and granulomatous angiitis of the basilar artery: demonstration of the varicella-zoster-virus in the basilar artery lesions . Stroke . 1986;;17:1024-1028.
5 +
Eidelberg D, Sotrel A, Horoupain S, et al.  Thrombotic cerebral vasculopathy associated with herpes zoster . Ann Neurol . 1986;;19:7-14.
6 +
Vartdal F, Vandvik B.  Imprint immunofixation of electrofocused immunoglobulins . J Immunol Methods . 1983;;62:23-29.
7 +
Källander CFR, Gronowitz JS,  Olding-Stenkvist E. Rapid diagnosis of varicella-zoster virus infection by detection of viral deoxythymidine kinase in serum and vesicle fluid . J Clin Microbiol . 1983;;17:280-287.
8 +
Gronowitz JS, Källander CFR.  Extracellular expression of TK isozymes in human body fluids, with special reference to herpesvirus diagnostics and use for monitoring of antiviral therapy . In: Sanna A, Morace G, eds. New Horizons in Microbiology . Amsterdam, the Netherlands: Elsevier Science Publishers; 1984;:273-284.
9 +
Cohen JI, Corey GR.  Cytomegalovirus infection in the normal host . Medicine . 1985;;64:100-114.
10 +
Bourdette DN, Rosenberg NL, Yatsu FM.  Herpes zoster ophthalmicus and delayed ipsilateral cerebral infarction . Neurology . 1983;;33:1428-1432.
11 +
Reshef E, Greenberg SB, Jankovic J.  Herpes zoster ophthalmicus followed by contralateral hemiparesis: report of two cases and review of literature . J Neurol Neurosurg Psychiatry . 1985;;48:122-127.
12 +
Linnemann CC, Alvira MM.  Pathogenesis of varicella-zoster angiitis in the CNS . Arch Neurol . 1980;;37:239-240.
13 +
Grose C.  Variation on a theme by Fenner: the pathogenesis of chickenpox . Pediatrics . 1981;;68:735-737.
14 +
Mietens C.  Almost simultaneous occurrence of varicella and zoster in an otherwise healthy child . Pediatr Infect Dis . 1986;;5:482-483.
15 +
Mayo DR, Booss J.  Varicella zoster-associated neurologic disease without skin lesions . Arch Neurol . 1989;;46:313-315.
16 +
Kostulas VK, Link H, Lefvert AK.  Oligoclonal IgG bands in cerebrospinal fluid . Arch Neurol . 1987;;44:1041-1044.

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1 +
Golden GS.  Cerebrovascular disease . In: Swainman KF, ed. Pediatric Neurology . St Louis, Mo: CV Mosby Co; 1989;:603-623.
2 +
Gold AP, Carter S.  Acute hemiplegia of infancy and childhood . Pediatr Clin North Am . 1976;;23:413-433.
3 +
Hilt DC, Buchholz D, Krumholz A, et al.  Herpes zoster ophthalmicus and delayed contralateral hemiparesis caused by cerebral angiitis: diagnosis and management approaches . Ann Neurol . 1983;;14:543-553.
4 +
Fukumoto S, Mitsuru K, Hokamura K, et al.  Subarachnoid hemorrhage and granulomatous angiitis of the basilar artery: demonstration of the varicella-zoster-virus in the basilar artery lesions . Stroke . 1986;;17:1024-1028.
5 +
Eidelberg D, Sotrel A, Horoupain S, et al.  Thrombotic cerebral vasculopathy associated with herpes zoster . Ann Neurol . 1986;;19:7-14.
6 +
Vartdal F, Vandvik B.  Imprint immunofixation of electrofocused immunoglobulins . J Immunol Methods . 1983;;62:23-29.
7 +
Källander CFR, Gronowitz JS,  Olding-Stenkvist E. Rapid diagnosis of varicella-zoster virus infection by detection of viral deoxythymidine kinase in serum and vesicle fluid . J Clin Microbiol . 1983;;17:280-287.
8 +
Gronowitz JS, Källander CFR.  Extracellular expression of TK isozymes in human body fluids, with special reference to herpesvirus diagnostics and use for monitoring of antiviral therapy . In: Sanna A, Morace G, eds. New Horizons in Microbiology . Amsterdam, the Netherlands: Elsevier Science Publishers; 1984;:273-284.
9 +
Cohen JI, Corey GR.  Cytomegalovirus infection in the normal host . Medicine . 1985;;64:100-114.
10 +
Bourdette DN, Rosenberg NL, Yatsu FM.  Herpes zoster ophthalmicus and delayed ipsilateral cerebral infarction . Neurology . 1983;;33:1428-1432.
11 +
Reshef E, Greenberg SB, Jankovic J.  Herpes zoster ophthalmicus followed by contralateral hemiparesis: report of two cases and review of literature . J Neurol Neurosurg Psychiatry . 1985;;48:122-127.
12 +
Linnemann CC, Alvira MM.  Pathogenesis of varicella-zoster angiitis in the CNS . Arch Neurol . 1980;;37:239-240.
13 +
Grose C.  Variation on a theme by Fenner: the pathogenesis of chickenpox . Pediatrics . 1981;;68:735-737.
14 +
Mietens C.  Almost simultaneous occurrence of varicella and zoster in an otherwise healthy child . Pediatr Infect Dis . 1986;;5:482-483.
15 +
Mayo DR, Booss J.  Varicella zoster-associated neurologic disease without skin lesions . Arch Neurol . 1989;;46:313-315.
16 +
Kostulas VK, Link H, Lefvert AK.  Oligoclonal IgG bands in cerebrospinal fluid . Arch Neurol . 1987;;44:1041-1044.

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