IVIG treatment for VZV-related acute inflammatory polyneuropathy in a child

BMJ Case Rep. 2012 Jul 19:2012:bcr2012006362. doi: 10.1136/bcr-2012-006362.

Abstract

Acute inflammatory polyneuropathy is an inflammatory demyelinating disease triggered by an autoimmune mechanism. It follows an infection or an immunisation after a free interval of 2-30 days. We report a case of a 14-year-old boy who develops an acute rapidly progressive paraplegia, urine incontinence and positive Lasegue a week after a characteristic chickenpox rash. Spinal MRI showed diffuse thickening and leptomeningeal enhancement of cauda equina nerve roots. Intravenous immunoglobulins were given and yielded a dramatic clinical and radiological improvement. The patient was discharged without any clinical problems 1 month after the onset of symptoms. We performed a review of the literature, discussing the different forms of varicella-zoster virus-related central and peripheral nervous system complications and management strategies for acute postinfectious encephalomyelitis/radiculitis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Diagnosis, Differential
  • Guillain-Barre Syndrome / diagnosis
  • Guillain-Barre Syndrome / drug therapy*
  • Guillain-Barre Syndrome / virology
  • Herpesvirus 3, Human
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors / therapeutic use
  • Magnetic Resonance Imaging
  • Male

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors