oxadiazoles and Guillain-Barre-Syndrome

A 76-year-old Japanese female who was treated with long-term use of prednisolone at 10 mg/day for interstitial pneumonia developed acute right-dominant lower limb paralysis and then upper limb paralysis with herpes zoster eruptions on the right C7-Th1 dermatomes. On admission, right predominant quadriplegia was observed with sensory symptoms; Hughes functional grade was level 4; the hand grip power was right, 0, and left, 7 kg, the deep tendon reflexes were abolished throughout without pathologic reflexes. Twenty days after the onset of the symptoms, the cerebrospinal fluid (CSF) revealed mild increases of lymphocytes (13 cells/μl) and protein content (73 mg/dl). Varicella-zoster virus (VZV) PCR was negative in the CSF, but an enzyme immunoassay for VZV was positive in her serum and CSF, and the high titers were prolonged. Peripheral nerve conduction and F wave studies suggested right-dominant demyelinating polyradiculoneuropathy. A T

Topics: Acyclovir; Aged; Antibodies, Viral; Antiviral Agents; Biomarkers; Diffusion Magnetic Resonance Imaging; Female; Guillain-Barre Syndrome; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Oxadiazoles; Polyradiculoneuropathy; Quadriplegia; Varicella Zoster Virus Infection