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lüll Neurological disease produced by varicella zoster virus reactivation without rash Gilden D; Cohrs RJ; Mahalingam R; Nagel MACurr Top Microbiol Immunol 2010[]; 342 (ä): 243-53Reactivation of varicella zoster virus (VZV) from latently infected human ganglia usually produces herpes zoster (shingles), characterized by dermatomal distribution pain and rash. Zoster is often followed by chronic pain (postherpetic neuralgia or PHN) as well as meningitis or meningoencephalitis, cerebellitis, isolated cranial nerve palsies that produce ophthalmoplegia or the Ramsay Hunt syndrome, multiple cranial nerve palsies (polyneuritis cranialis), vasculopathy, myelopathy, and various inflammatory disorders of the eye. Importantly, VZV reactivation can produce chronic radicular pain without rash (zoster sine herpete), as well as all the neurological disorders listed above without rash. The protean neurological and ocular disorders produced by VZV in the absence of rash are a challenge to the practicing clinician. The presentation of these conditions varies from acute to subacute to chronic. Virological confirmation requires the demonstration of amplifiable VZV DNA in cerebrospinal fluid (CSF) or in blood mononuclear cells, or the presence of anti-VZV IgG antibody in CSF or of anti-VZV IgM antibody in CSF or serum.|Cranial Nerve Diseases/virology[MESH]|Herpes Zoster Oticus/virology[MESH]|Herpes Zoster/*virology[MESH]|Herpesvirus 3, Human/*physiology[MESH]|Humans[MESH]|Neuralgia, Postherpetic/virology[MESH]|Spinal Cord Diseases/virology[MESH]|Virus Activation[MESH]|Zoster Sine Herpete/*virology[MESH] |