Herpes Zoster Cervical Myelitis in a Young Adult

Varicella zoster virus infection, which causes chickenpox and herpes zoster (HZ), is not uncommon in the general population. Varicella zoster virus can be latent in cranial nerve or dorsal root ganglia, and reactivate several decades later to produce vesicles with post-herpetic neuralgia. HZ myelitis usually occurs in elderly or immunocompromised patients. We report here a case of HZ myelitis of the cervical spinal cord in a 35-year-old woman who was immunocompetent. Cervical myelitis developed 1 month after the eruption of vesicles. Pure sensation loss was limited initially from the C2 to T1 dermatomes, but later progressed to lower limb sensory loss and sphincter function impairment. The patient's motor function was also mildly affected. Despite the initial rapid neurological deterioration, the symptoms dramatically improved after 5 days of parenteral acyclovir and steroid administration with rehabilitation. We therefore propose that early medical intervention is necessary for better and earlier recovery.