Background Varicella zoster virus primary infection is responsible for chickenpox, whereas secondary infection or reactivation can lead to a variety of clinical scenarios. If latent infection is established in trigeminal ganglion, the reactivation can determine viral migration to cerebral arteries, which causes a cerebral vasculopathy and subsequently an ischemic stroke. Patients Here we report on a child experiencing recurrent episodes of headache mimicking a trigeminal autonomic cephalalgia, in the absence of any skin rash, which were followed by the occurrence of an ipsilateral hemiparesis associated with a choreic movement disorder a month later. Results Magnetic resonance angiography showed evidence of a right-sided infarction of basal ganglia and anterior limb of the internal capsule, corresponding to the vascular territory of the recurrent artery of Heubner, as a consequence of a focal varicella zoster virus arteriopathy. Conclusions We suggest that the recognition of this prodromal manifestation, which can be interpreted as a zoster sine herpete, could provide clinicians an extremely useful time window to start promptly with a prophylactic treatment. © 2013 Elsevier Inc. All rights reserved.

Unusual trigeminal autonomic pain heralding hemichorea due to Zoster Sine herpete vasculopathy / Spagnoli, C.; Cantalupo, G.; Piccolo, B.; Cerasti, D.; Pisani, F.. - In: PEDIATRIC NEUROLOGY. - ISSN 0887-8994. - 49:3(2013), pp. 205-208. [10.1016/j.pediatrneurol.2013.04.003]

Unusual trigeminal autonomic pain heralding hemichorea due to Zoster Sine herpete vasculopathy

Pisani F.
2013

Abstract

Background Varicella zoster virus primary infection is responsible for chickenpox, whereas secondary infection or reactivation can lead to a variety of clinical scenarios. If latent infection is established in trigeminal ganglion, the reactivation can determine viral migration to cerebral arteries, which causes a cerebral vasculopathy and subsequently an ischemic stroke. Patients Here we report on a child experiencing recurrent episodes of headache mimicking a trigeminal autonomic cephalalgia, in the absence of any skin rash, which were followed by the occurrence of an ipsilateral hemiparesis associated with a choreic movement disorder a month later. Results Magnetic resonance angiography showed evidence of a right-sided infarction of basal ganglia and anterior limb of the internal capsule, corresponding to the vascular territory of the recurrent artery of Heubner, as a consequence of a focal varicella zoster virus arteriopathy. Conclusions We suggest that the recognition of this prodromal manifestation, which can be interpreted as a zoster sine herpete, could provide clinicians an extremely useful time window to start promptly with a prophylactic treatment. © 2013 Elsevier Inc. All rights reserved.
2013
Varicella zoster; chickenpox; trigeminal autonomic cephalalgia
01 Pubblicazione su rivista::01a Articolo in rivista
Unusual trigeminal autonomic pain heralding hemichorea due to Zoster Sine herpete vasculopathy / Spagnoli, C.; Cantalupo, G.; Piccolo, B.; Cerasti, D.; Pisani, F.. - In: PEDIATRIC NEUROLOGY. - ISSN 0887-8994. - 49:3(2013), pp. 205-208. [10.1016/j.pediatrneurol.2013.04.003]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1670218
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact