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- Itamar Niesvizky-Kogan, Indrit Greca, and Harvir Singh Gambhir.
- Department of Medicine, SUNY Upstate Medical University, United States of America. Electronic address: iniesvizky@gmail.com.
- Am J Emerg Med. 2019 Mar 1; 37 (3): 564.e5-564.e6.
AbstractCranial polyneuropathy is commonly caused by Lyme disease. We discuss the case of a man who presented with cranial nerve deficits causing dysphagia, dysphonia and facial weakness. This diagnostic dilemma stemmed from a workup that ruled out Lyme and vascular causes leading to an expanded search for infectious explanations, which revealed varicella zoster in the cerebrospinal fluid. On review, this phenomenon is rarely reported, but has been observed with a number of herpes family viruses. In emergency department settings, clinical suspicion should be raised for VZV infection even in the absence of rash in patients that present with multiple cranial nerve palsies.Copyright © 2018. Published by Elsevier Inc.
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