Symptoms Of Lewy-Body Dementia Induced By Herpes Zoster Encephalitis

Varicella-Zoster virus (VZV) reactivation syndromes have been shown to have a multitude of neurologic sequelae, including vasculopathy and encephalitis. Complications of Herpes Zoster Encephalitis (HZE) have not been adequately studied, due to the rare and variable presentation of the condition. However, case reports have shown outcomes ranging from favorable to fatal. We present the case of a 65-year-old male who presented with Herpes Zoster Meningoencephalitis, who developed symptoms suggestive of Lewy-Body Dementia (LBD) during the acute phase of his illness, which continued to progress. While no virus has been conclusively implicated in a neurodegenerative disease process, there is some evidence to suggest neurotropic viruses play a role in neurodegeneration. The temporal relationship between this patient’s acute viral infection and the onset of hallucinations, cognitive changes, REM behavior disorder and parkinsonism point to a possible causative relationship. Whether the HZE unmasked an early LBD or initiated a degenerative process with similarities to LBD remains unclear. In this report we discuss details of this unique case and review the available literature surrounding the impact of VZV in the central nervous system.