Varicella zoster virus

Encephalitis accounts for 90% of the neurological complications of varicella, which are in themselves rare, affecting only 01% of cases.24,25 In half, the encephalitis is of the cerebellar type with ataxia, dysarthria, headache, and drowsiness coming on about a week after the rash begins, but the neurological onset may precede the rash. Convulsions are common26 and progression to hemiplegia, cranial nerve palsies, aphasia, and coma may ensue. Patients with the cerebellar form usually recover completely but 10% of those with the general form die. Encephalitis may rarely follow shingles.27 Management of VZV-associated encephalitis is with aciclovir as described for HSE.

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