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The Variegate Neurological Manifestations of Varicella Zoster Virus Infection

  • Infection (J Berger)
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Abstract

Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which the virus becomes latent in ganglionic neurons along the entire neuraxis. With advancing age or immunosuppression, cell-mediated immunity to VZV declines, and the virus reactivates to cause zoster (shingles), dermatomal distribution, pain, and rash. Zoster is often followed by chronic pain (postherpetic neuralgia), cranial nerve palsies, zoster paresis, vasculopathy, meningoencephalitis, and multiple ocular disorders. This review covers clinical, laboratory, and pathological features of neurological complications of VZV reactivation, including diagnostic testing to verify active VZV infection in the nervous system. Additional perspectives are provided by discussions of VZV latency, animal models to study varicella pathogenesis and immunity, and of the value of vaccination of elderly individuals to boost cell-mediated immunity to VZV and prevent VZV reactivation.

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Acknowledgments

This work was supported by NIH grants AG006127 to DG, AG032958 to DG, RJC and RM, NS082228 to RJC, and NS067070 to MAN.

We thank Marina Hoffman for editorial assistance and Lori DePriest for help with the manuscript preparation.

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Conflict of Interest

All authors report no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Departments of Neurology and Microbiology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Box B182, Aurora, CO, 80045, USA

    Don Gilden

  2. Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA

    Maria A. Nagel, Randall J. Cohrs & Ravi Mahalingam

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  1. Don Gilden
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  2. Maria A. Nagel
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  3. Randall J. Cohrs
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  4. Ravi Mahalingam
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Correspondence to Don Gilden.

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This article is part of the Topical Collection on Infection

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Gilden, D., Nagel, M.A., Cohrs, R.J. et al. The Variegate Neurological Manifestations of Varicella Zoster Virus Infection. Curr Neurol Neurosci Rep 13, 374 (2013). https://doi.org/10.1007/s11910-013-0374-z

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