Cranial Polyneuritis due to Herpes Zoster Sine Herpete: A Series of Three Clinical Cases
DOI:
https://doi.org/10.46531/sinapse/CC/167/2026Keywords:
Herpes Zoster, Deglutition Disorders, Neuritis, Varicella Zoster Virus Infection, Zoster Sine HerpeteAbstract
Neurological manifestations of varicella-zoster virus (VZV) infection may include postherpetic neuralgia, cranial polyneuritis, meningoencephalitis, and vasculopathy, among others. Zoster sine herpete refers to a neurological condition with VZV etiology, in the absence of the characteristic vesicular rash. Three clinical cases of sudden-onset dysphonia and dysphagia without vesicular rash are presented. Computed tomography and contrast-enhanced magnetic resonance imaging (MRI) of the head and neck were unremarkable. VZV DNA was detected in the cerebrospinal fluid of two patients, while serology was positive in the blood of the third patient. All patients underwent a course of intravenous acyclovir, achieving recovery from neurological deficits. Zoster sine herpete presents a diagnostic challenge. It is crucial to suspect this nosological entity in atypical viral presentations to ensure timely therapeutic intervention and improve prognosis. Vaccination should be recommended for immunocompromised patients to reduce the incidence of neurological complications associated with VZV reactivation.
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Copyright (c) 2026 Mariana Pereira, Afonso Silva, Nancy Faria, Ana Isabel Gonçalves, Duarte Noronha, Teresa Carolina Aguiar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
