A case of cerebellar ataxia associated with VZV infection

Abstract

The varicella zoster virus (VZV) is a neurotropic virus that becomes latent in the sensory ganglia, but later causes various neurologic complications such as meningitis, encephalitis, myelitis, meningoencephalitis, cranial neuropathy, and peripheral neuropathy [1]. While acute cerebellitis is one of the most frequent acute cerebellar diseases associated with VZV in childhood, VZV rarely causes cerebellitis in adults, with or without skin manifestations, and only a few isolated cases of adult VZV cerebellitis have been reported. We report a case of acute cerebellitis associated with VZV infection after a herpetic rash in an 80-year-old male. Functional imaging of his cerebellum showed high blood perfusion during the acute stage of the disease, though perfusion decreased in the subacute stage.

Keywords: Acute cerebellitis; CSF, cerebrospinal fluid; Hyperperfusion; IgG, immunoglobulin G; MRI, magnetic resonance imaging; PCR, polymerase chain reaction; SPECT, single photon emission computed tomography; VZV infection; VZV, varicella zoster virus.

Fig. 1

Axial brain SPECT. The initial brain SPECT results are shown in panels A and B, and the follow-up brain SPECT results after 40 days are shown in panels C and D.