Varicella zoster presenting as cranial polyneuropathy

Cranial polyneuropathy is commonly caused by Lyme disease. We discuss the case of a man who presented with cranial nerve deficits causing dysphagia, dysphonia and facial weakness. This diagnostic dilemma stemmed from a workup that ruled out Lyme and vascular causes leading to an expanded search for infectious explanations, which revealed varicella zoster in the cerebrospinal fluid. On review, this phenomenon is rarely reported, but has been observed with a number of herpes family viruses. In emergency department settings, clinical suspicion should be raised for VZV infection even in the absence of rash in patients that present with multiple cranial nerve palsies.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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der F Abstract Introduction: Despite advancements in diagnostic capabilities and the availability of effective antimicrobial agents, community-acquired infections of the central nervous system (CNS) are still associated with high mortality rates. Aim: To assess the epidemiological and clinical characteristics of community-acquired CNS infections treated in the West Pannonian region between 2010 and 2016. Method: Clinical data of 176 patients were retrospectively analysed in two age cohorts: 15 to 65 and more than 65 years of age. Results: Neuroinfections were found to be bacterial in 81, viral in 91, parasitic in ...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusions OCB are important biomarkers that can support MRI diagnostics and help to avoid false-positive MS diagnoses. Therefore, the revised McDonalds criteria have increased the importance of the OCB. New biomarkers such as AQP4 have now established themselves in clinical practice, and others such as Anti-MOG and NfL are about to enter clinical routine. An important focus in the search for new biomarkers is the monitoring of therapy efficacy and the prediction of severe side effects. Many other CSF molecules such as CHI3L1, IL-6, or CXCL13 show potential as markers for clinical practice, but further research is nee...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Authors: Sekelj A, Đanić D Abstract Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes si...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
Conclusions: The clinical presentation of unilateral, posterior interstitial keratitis may be a rare manifestation of herpes simplex virus keratitis.
Source: Cornea - Category: Opthalmology Tags: Case Report Source Type: research
The facial paralysis and drooping is caused by nerve inflammation, but the cause of that inflammation “ is a question for the ages ” says one expert.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Immune System Bell's Palsy Herpes Viruses Steroids Lyme Disease Nerves and Nervous System Source Type: news
We report such a case of bilateral rickettsial retinitis proven by serology which worsened on systemic steroids and responded dramatically to therapy with oral doxycycline and steroid taper. We thus believe that direct bacterial invasion plays a major role in the pathogenesis of rickettsial retinitis.
Source: Indian Journal of Ophthalmology - Category: Opthalmology Authors: Source Type: research
ConclusionsAutonomic dysfunction may be responsible for additional morbidity in some infectious diseases.
Source: Clinical Autonomic Research - Category: Research Source Type: research
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