acyclovir and Motor-Neuron-Disease

We describe a patient with zoster paresis and an MRI that revealed extensive spinal cord lesions from the upper cervical to the lower thoracic spinal cord. Importantly, the patient reported considerable spontaneous improvement in strength 2-3 weeks after zoster. This report reveals a previously undescribed remarkable preponderance of MRI lesions far beyond the site of zoster rash and focal lower motor neuron weakness.

Topics: Acyclovir; Aged; Antiviral Agents; Exanthema; Female; Herpes Zoster; Humans; Magnetic Resonance Imaging; Motor Neuron Disease; Muscle Weakness; Spinal Cord; Spinal Nerve Roots; Valacyclovir; Valine

Describe the case of an Anterior Cord Syndrome secondary to transverse myelitis. ANTERIOR CORD SYNDROME: Anterior Cord syndrome (ACS) is characterized by a lesion that affects the anterior two thirds of the spinal cord while preserving the posterior columns. TRANSVERSE MYELITIS: Transverse myelitis (TM) is an inflammatory disorder with a heterogeneous pathogenesis affecting the spinal cord at one or more segments, resulting in motor, sensory, and autonomic dysfunction in the absence of a preexisting neurological disease or spinal cord compression.. The patient was treated with methylprednisolone, IV Antibiotics, acyclovir, and inpatient rehabilitation.. The patient significantly improved her function throughout inpatient rehabilitation and was discharged after achieving modified independent level with ambulation and all activities of daily living. The patient also gained independence with an intermittent catheterization program and a nightly bowel program, which included suppository and digital stimulation.. This case illustrates the first documented pediatric patient with a unique case of Anterior Cord Syndrome caused by idiopathic transverse myelitis.

Topics: Activities of Daily Living; Acyclovir; Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antiviral Agents; Autonomic Nervous System Diseases; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Methylprednisolone; Motor Neuron Disease; Myelitis, Transverse; Physical Therapy Modalities; Rehabilitation Nursing; Sensation Disorders; Spinal Cord; Syndrome; Treatment Outcome

Brachial plexus neuritis in the presence of herpes zoster infection is uncommon. Motor involvement is probably due to the spreading of inflammation from the dorsal root ganglia to the ventral roots and may be more extensive than the affected dermatomes. We present a case of herpes zoster brachial plexopathy with pure motor involvement both clinically and electrophysiologically.

Topics: Acyclovir; Aged; Antibodies, Viral; Antiviral Agents; Arm; Axons; Brachial Plexus Neuropathies; Electrodiagnosis; Electromyography; Exanthema; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Motor Neuron Disease; Motor Neurons; Muscle Weakness; Muscle, Skeletal; Muscular Atrophy; Neural Conduction; Spinal Nerve Roots; Treatment Failure; Wallerian Degeneration