THE VALUE OF CEREBROSPINAL-FLUID ANTIVIRAL ANTIBODY IN THE DIAGNOSIS OF NEUROLOGIC DISEASE PRODUCED BY VARICELLA-ZOSTER VIRUS

We studied four patients with subacute to chronic varicella tester vir us (VZV) infection of the central nervous system (CNS). VZV infection was verified by detecting antibody to VZV in the cerebrospinal fluid ( CSF). VZV caused myelitis in two patients and encephalitis in two pati ents. In one of the patients with VZV encephalitis, in addition to VZV IgM antibody, VZV DNA was found in the CSF. Among the four patients w ith VZV infection of the CNS, CSF antibody to VZV was the crucial diag nostic laboratory test which corroborated the clinical features,and in dicated that VZV caused neurologic disease. In addition to looking for amplifiable VZV DNA in the CSF of patients with neurologic disease wh ose clinical and radiologic features suggest VZV infection, we also re commend a search for CSF antibody to VZV, particularly in patients wit h intervals of weeks to months between tester and the onset of neurolo gic disease, or in those patients without rash in whom the tempo of il lness is unknown. (C) 1998 Elsevier Science B.V. All rights reserved.