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Rare disease
CASE REPORT
Varicella zoster lumbosacral plexopathy: a rare cause of lower limb weakness
  1. Timothy Michael Archer
  1. General Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  1. Correspondence to Dr Timothy Michael Archer, timothy.archer.2015{at}gmail.com

Summary

This is a rare case of Varicella zoster virus (VZV) lumbosacral plexopathy in an 84-year-old women presenting with lower limb weakness and rash. Contrast-enhanced MRI showed enhancement of the left L3–L5 descending nerves and left lumbosacral plexus consistent with inflammatory/infectious aetiology. Cerebrospinal fluid PCR confirmed VZV DNA and cerebrospinal fluid serological testing was positive for VZV immunoglobulin (Ig)M and IgG antibodies. The patient was treated with intravenous acyclovir but this was complicated by the development of acute renal failure attributed to acyclovir-induced nephropathy, requiring dose adjustment. After a prolonged course of oral acyclovir and inpatient rehabilitation, the patient made a partial neurological and functional recovery.

  • infectious diseases
  • infection (neurology)
  • neuroimaging
  • radiology
  • pain (neurology)

https://doi.org/10.1136/bcr-2017-223947

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    Footnotes

    • Contributors TMA: planning, drafting of report, research and clinical follow-up.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.