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Herpes zoster myelitis treated with acyclovir.

Varicella zoster virus (VZV) is a human herpes virus which causes both varicella (chickenpox) and herpes zoster (HZ). HZ is a sporadic illness and is characterized by a painful vesicular cutaneous eruption along the distribution of cutaneous sen­ sory dermatomes. The neurological complications include segmental motor or sensory loss, cranial nerve involvement, encephalitis, myelitis, Guillain­ Barre syndrome, cerebral vasculitis, multifocal leucoencephalitic syndrome and post herpetic neuralgia (Kennedy, 1987). Clinical myelopathy from HZ is distinctly unusual and usually develops in the immunocompromised host. In large series, the incidence varies from 0 to 0.8% in the general population or in immunosuppressed patients, respectively (Devinsky, 1991). In the past, treat­ ment was only symptomatic. Recently antiviral chemotherapy has been effective for patients with VZV, particularly acyclovir (Prober et ai, 1982; Shepp et ai, 1986). However the therapeutic efficacy of this drug in HZ myelitis could not be assessed because of limited data. We report a case of HZ myelitis and the results of therapy with acyclovir.