Varicella zoster virus encephalitis

Varicella zoster virus (VZV) encephalitis can be due to either an immune reaction to primary infection or reactivation of latent infection in cranial nerve or dorsal root ganglia following childhood chickenpox. 

Manifestations following primary infection include: 

• cerebellar ataxia
• meningoencephalitis
• transverse myelitis
• aseptic meningitis

Manifestations of secondary reactivation include:

• neuritis / plexitis
  • herpes zoster ophthalmicus
  • Ramsay Hunt syndrome
• myelitis
• Bickerstaff encephalitis (rare)

Immunocompromised patients have a much wider range of manifestations and not surprisingly, these tend to be more serious. In addition to those listed above, they also include:

• VZV vasculitis
• chronic VZV encephalitis