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Revue Neurologique
Volume 165, n° 10
pages 836-838 (octobre 2009)
Doi : 10.1016/j.neurol.2008.10.016
Received : 17 Mars 2008 ;  accepted : 8 October 2008
Diplégie faciale au cours d’une neuropathie démyélinisante inflammatoire aiguë secondaire à une varicelle
Facial diplegia and acute inflammatory demyelinating neuropathy secondary to varicella
 

R. Juntas Morales , J.-N. Tillier, P. Davous
Service de neurologie, centre hospitalier Victor-Dupouy, Argenteuil, France 

Auteur correspondant . Service de neurologie, hôpital Gui-de-Chauliac, CHU de Montpellier, 34295 Montpellier cedex 5, France.
Résumé
Introduction

La primo-infection par le virus herpès zoster est responsable de nombreuses complications neurologiques dont de rares cas de paralysie faciale bilatérale.

Observation

Nous rapportons le cas d’une femme âgée de 38ans qui développa une diplégie faciale bilatérale d’installation subaiguë accompagnée de paresthésies au niveau des membres quelques jours après une primo-infection par varicelle. Parmi les examens complémentaires, il existait une hyperprotéinorachie et l’EMG montrait la présence d’une polyneuropathie démyélinisante. Le diagnostic évoqué était celui d’un syndrome de Guillain-Barré et un traitement par immunoglubulines intraveineuses fut réalisé avec amélioration progressive des symptômes.

Conclusion

L’immunothérapie est une attitude possible face aux atteintes neurologiques postvaricelles où le mécanisme auto-immun paraît le plus probable.

The full text of this article is available in PDF format.
Abstract
Introduction

Primo-infection by varicella-zoster virus (VZV) may be associated with several neurologic complications. Bilateral facial palsy is a rather uncommon manifestation.

Case report

We report the case of a 38-year-old woman who developed bilateral facial diplegia and paresthesia affecting all four limbs with subacute onset several days after varicella virus primoinfection. Ancillary tests showed hyperproteinorachia and signs of demyelinating polyneuropathy in nerve conduction tests. The diagnosis of Guillain-Barré syndrome was retained and a treatment with intravenous immunoglobulines was started, leading to progressive improvement.

Conclusion

Immunotherapy is a possible therapeutic approach in the context of neurologic postinfectious complications after VZV infection where an underlying mechanism is probable.

The full text of this article is available in PDF format.

Mots clés : Varicelle, Infection, Paralysie faciale, Syndrome de Guillain-Barré, Immunothérapie

Keywords : Facial paralysis, Chickenpox, Infection, Guillain-Barré syndrome, Immunotherapy




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