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- Title
Herpes simplex Virus type 2 Myelitis: Case Report and Review of the Literature.
- Authors
Nardone, Raffaele; Versace, Viviana; Brigo, Francesco; Tezzon, Frediano; Zuccoli, Giulio; Pikija, Slaven; Hauer, Larissa; Sellner, Johann
- Abstract
Non-traumatic myelopathies can result from a wide spectrum of conditions including inflammatory, ischemic, and metabolic disorders. Here, we describe the case of a 60-year old immunocompetent woman who developed acute back pain followed by rapidly ascending flaccid tetraparesis, a C6 sensory level, and sphincter dysfunction within 8 h. Acyclovir and steroids were started on day 2 and herpes simplex virus type 2 (HSV-2) was confirmed by polymerase chain reaction in cerebrospinal fluid. Magnetic resonance imaging revealed a bilateral anterior horn tractopathy expanding from C2 to T2 and cervicothoracic cord swelling. Screening for paraneoplastic antibodies and cancer was negative. Neurophysiology aided in the work-up by corroborating root involvement. Recovery was poor despite early initiation of antiviral treatment, adjuvant antiinflammatory therapy, and neurorehabilitation efforts. The clinical course, bilateral affection of the anterior horns, and early focal atrophy on follow-up magnetic resonance imaging take a necrotizing myelitis potentially caused by intraneuronal spread of the virus into consideration. Further, we summarize the literature on classical and rare presentations of HSV-2 myeloradiculitis in non-immunocompromised patients and raise awareness for the limited treatment options for a condition with frequent devastating outcome.
- Subjects
MYELITIS; SPINAL cord diseases; HERPES simplex virus
- Publication
Frontiers in Neurology, 2017, p1
- ISSN
1664-2295
- Publication type
Case Study
- DOI
10.3389/fneur.2017.00199