scholarly journals Post Varicella Angiopathy as a Cause of Pediatric Stroke: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 36-39
Author(s):  
Anju Bala ◽  
Parul Bhardwaj ◽  
Vipan Garg
Keyword(s):  
Ischemic Stroke ◽  
Motor Neuron ◽  
Varicella Zoster Virus ◽  
Facial Nerve Palsy ◽  
Internal Capsule ◽  
Neurological Complications ◽  
Arterial Ischemic Stroke ◽  
Varicella Infection ◽  
Varicella Zoster ◽  
Double Stranded Dna

Varicella-zoster virus is a neurotropic herpes virus that contains double stranded DNA. It can cause primary, latent and reactivation infection. Chickenpox is the primary manifestation and result in life long latent infection of sensory neurons. Varicella infection is usually self limiting and complications occur mostly in immunocompromised patients. The most common neurological complications following varicella infection are cerebellar ataxia and encephalitis but arterial ischemic stroke in pediatric patient is also significant. Post varicella angiopathy also published under transient cerebral arteriopathy and is nearly always self -limited and may be the result of focal inflammation1. Arterial ischemic stroke may occur during the course of varicella infection or one week to several months after the appearance of rash. Here we present a case of 6 years old male who presented with right hemiparesis with right sided facial nerve palsy two months after chickenpox. An MRI was done which was suggestive of hyperintensities in basal ganglia and internal capsule in T-1 weighted MRI. Although the weakness was self-limiting patient was treated with aspirin in addition to supportive measures. Keywords: Arterial ischemic stroke, Post varicella angiopathy, Varicella zoster virus, Middle cerebral artery, Upper motor neuron, Lower motor neuron.

scholarly journals Molecular Aspects of Varicella-Zoster Virus Latency

2018 ◽  
Author(s):  
Daniel P. Depledge ◽  
Tomohiko Sadaoka ◽  
Werner J. D. Ouwendijk
Keyword(s):  
Varicella Zoster Virus ◽  
Molecular Mechanisms ◽  
Neurological Complications ◽  
In Vitro Models ◽  
New Era ◽  
Varicella Zoster ◽  
Virus Latency ◽  
Technological Advances ◽  
Molecular Aspects

Primary varicella-zoster virus (VZV) infection causes varicella (chickenpox) and the establishment of a lifelong latent infection in ganglionic neurons. VZV reactivates in about one-third of infected individuals to cause herpes zoster, often accompanied by neurological complications. The restricted host range of VZV and, until recently, the lack of suitable in vitro models to study VZV latency have seriously hampered molecular studies of viral latency. Nevertheless, recent technological advances facilitated a series of exciting studies that resulted in the discovery of a VZV latency-associated transcript (VLT) and have redefined our understanding of VZV latency and factors that initiate reactivation. Together, these findings pave the way for a new era of research that may finally unravel the precise molecular mechanisms that govern latency. In this review, we will summarize the implications of recent discoveries in the VZV latency field from both a virus and host perspective and provide a roadmap for future studies.

scholarly journals Risk factors, types and outcomes of arterial ischemic stroke in Polish pediatric patients: a retrospective single-center study

2021 ◽  
Vol 17 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Beata Sarecka-Hujar ◽  
Ilona Kopyta ◽  
Dorota Raczkiewicz
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Pediatric Patients ◽  
Age At Onset ◽  
Neurological Complications ◽  
Arterial Ischemic Stroke ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Post Stroke ◽  
Normal Outcome

IntroductionVarious neurological complications may occur as a consequence of arterial ischemic stroke (AIS) and have an impact on daily activity of the patients, costs of their medical care and rehabilitation. The aim of this study was to analyze risk factors, stroke symptoms and post-stroke consequences in Polish pediatric patients depending on stroke subtype.Material and methodsWe retrospectively reviewed 77 children under the age of 18 years following their first AIS. Patients were white, Polish Caucasians, recruited in the Department of Pediatric Neurology at the Medical University of Silesia in Katowice (Poland). Statistical analysis was performed using Statistica 12.0.ResultsGender differed significantly between stroke subgroups (p = 0.030). The presence of focal cerebral arteriopathy (FCA) and chronic diseases was associated with type of AIS (p = 0.003 and p = 0.050, respectively). An outcome without neurological deterioration (normal outcome) was observed in 43% of children with lacunar anterior circulation infarct (LACI). Hemiparesis was present in almost all children with total anterior circulation infarct (TACI), in two thirds of children with partial anterior circulation infarct (PACI) and in almost 50% of children with LACI or posterior circulation infarct (POCI). In every child with hemiplegia the stroke symptom evolved into hemiparesis at follow-up. Additionally, patients with a normal outcome were older at the time of AIS than those with at least one neurological consequence (OR = 0.894, p = 0.034).ConclusionsThe presence and number of neurological outcomes depend on stroke subtypes. A relation between the presence of post-stroke deficits and age at onset was observed. The odds of deficit after ischemic stroke decreases by an average of 10.6% if the child is 1 year older at the time of AIS.

scholarly journals Isolated Lower Motor Neuron Facial Nerve Palsy in a Patient of Varicella: A Case Report

2020 ◽  
Vol 58 (224) ◽  
Author(s):  
Sanjiv Choudhary ◽  
Ankita Srivastava ◽  
Soumya Narula
Keyword(s):  
Facial Nerve ◽  
Motor Neuron ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Indian Subcontinent ◽  
Neurological Complications ◽  
Lower Motor Neuron ◽  
Cutaneous Lesions ◽  
Oral Corticosteroids ◽  
Motor Neuron Facial Nerve

Varicella or chickenpox is usually regarded as a self-limiting disease, but occasionally it may leadto irreversible neurological complications. Isolated lower motor neuron facial nerve palsy is a rarecomplication of varicella, with very few cases reported from the Indian subcontinent. We report onesuch case, where the patient developed facial palsy after healing of cutaneous lesions and recoveredcompletely with oral corticosteroids.

Primary varicella zoster virus infection-related hemiparesis and fatal neurological complications in an immunocompetent girl

2019 ◽  
Vol 32 (6) ◽  
pp. 381
Author(s):  
VijayP Bondre ◽  
AvinashR Deoshatwar ◽  
SthitaPragnya Behera ◽  
Niraj Kumar ◽  
BrijRanjan Misra ◽  
...  
Keyword(s):  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Neurological Complications ◽  
Varicella Zoster Virus Infection ◽  
Varicella Zoster

Abstract 38: Herpes Viruses in Childhood Arterial Ischemic Stroke: Interim Results of the VIPS Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Heather J Fullerton ◽  
Mitchell S Elkind ◽  
Carol A Glaser ◽  
Nancy K Hills ◽  
Jorge Luna ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
A Priori ◽  
Acute Infection ◽  
Multivariable Logistic Regression Analysis ◽  
Herpes Viruses ◽  
Arterial Ischemic Stroke ◽  
Vascular Effects ◽  
Recent Infection ◽  
Varicella Zoster ◽  
Hsv 1

Background: Varicella zoster virus (VZV) is a known cause of cerebral arteriopathy and arterial ischemic stroke (AIS) in children, and scant evidence suggests other herpes viruses may also play a role. An objective of the Vascular effects of Infection in Pediatric Stroke (VIPS) study was to determine whether recent infection with herpes viruses_as measured by serologies_is associated with childhood AIS. Methods: VIPS is an international prospective 35-center case-control study enrolling 350 children (28 days-18 years) with AIS and 120 unmatched trauma controls. Case confirmation and vascular imaging review are performed centrally. Acute blood samples are collected ≤3 weeks after stroke/trauma; convalescent samples 7-28 days after the acute draw in cases only. Samples were tested for IgG and IgM antibodies to herpes simplex virus (HSV) 1 and 2, cytomegalovirus (CMV), Epstein Barr virus (EBV), and VZV. An algorithm developed a priori by a pediatric infectious disease expert (C.A.G.) classified acute infection as a dichotomous variable. Results: Of 310 cases enrolled thus far, 141 cases with paired samples and 44 controls underwent serologic analysis. Median age (IQR) was 7.0 years (2.9, 14.3) for cases and 8.3 (3.3, 13.3) for controls (P=0.90). Evidence of an acute herpes infection was found in 41% of cases versus 9% of controls (P<0.0001; Table). The most commonly identified virus was HSV-1. After adjusting for age in a multivariable logistic regression analysis, herpes exposure remained a significant predictor of AIS (OR 9.0, 95% CI 3.1, 38.7; P=0.0004). Of the 58 cases positive for herpes, 36% had a definite arteriopathy, and 33% a possible arteriopathy, compared to 34% and 24%, respectively, of 83 negative cases. Conclusions: In this interim analysis, acute exposure to a herpes virus appears associated with childhood AIS, present in 41% of cases that were tested.

Factors Affect on development and clinical course of ischemic stroke in children

2016 ◽  
Vol 7 (4) ◽  
pp. 102-108 ◽  
Author(s):  
Alexey V Minin ◽  
Alexander B Palchik ◽  
Svetlana D Plotnikova
Keyword(s):  
Ischemic Stroke ◽  
Internal Capsule ◽  
Least Square Method ◽  
Structural Features ◽  
Partial Least Square ◽  
Least Square ◽  
Arterial Ischemic Stroke ◽  
Neurologic Outcomes ◽  
Neuroimaging Data ◽  
Occipital Lobes

Child strokes cause persistent neurologic impairment affecting on quality of life. Prophylaxis cerebral infarction in children promoted by Identification of factors influencing on development of ischemic stroke. 47 children with arterial ischemic stroke confirmed by MRI or CT was enrolled in cohort study. All children has focal neurological symptomatic which was assessed by pedNIHSS, PSOM, British muscular strength scale. General cerebral symptoms precede focal neurologic impairments in 67% cases. Fact of head trauma was documented in 55% observed children. Seizures occurs in 24% cases in acute period ischemic stroke. As major part of children had lacunar infarction in middle cerebral artery origin, so motor dysfunctions was admitted in clinical curse of general cases. By neuroimaging data we defined lacunar infarctions mainly in basal ganglia, thalamus and internal capsule. In the rest 5 cases - in cortex, white matter, frontal, parietal and occipital lobes, cerebellum and brain stem. In 10 children during observation over time the secondary haemorrhage at ischaemic site was detected. Besides post-ischemic alterations additional structural features was assessed in neuroimaging study. Calcification in white mater of brain was reviled in one third children with ischemic stroke (33,4%). Overwhelming majority calcifications in white mater of brain was diagnosed in lenticular-striatal arteries infarctions. Latent factors structure influenced on severity neurologic outcomes was received by partial least square method (PLS). Acquired data emphasize importance of mind depression, vertigo, dysphagia as poor outcome predictors.

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