Post chicken pox neurological sequelae: Three distinct presentations

Abstract

Varicella zoster infection is known to cause neurological involvement. The infection is usually self-limiting and resolves without sequelae. We present a series of three cases with neurological presentations following chicken pox infection. The first case is a case of meningitis, cerebellitis and polyradiculopathy, the second is a florid case of acute infective demyelinating polyradiculoneuropathy (Guillian-Barré syndrome) in a middle-aged female and the third case is a young man in whom we diagnosed acute transverse myelitis. All these cases presented with distinct neurological diagnoses and the etiology was established on the basis of history and serological tests confirmatory for chicken pox. The cases responded differently to treatment and the patients were left with minimum disability.

Keywords: Chicken pox; meningitis; polyradiculoneuropathy; transverse myelitis.

Figure 1

Enhancement of tentorium is seen in post-contrast T1- weighted imaging

Figure 2

NCV study showed diminished C-map of lower limb peroneal nerves, suggestive of asymmetric axononeuropathy

Figure 3

MRI dorsal spine T2 sagittal images show hyperintense signals involving dorsal cord