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CSF was abnormal in 28/46 patients (61%): pleocytosis (range, 5 to 1,440 uL) was detected in 21, elevated protein concentration in 12, varicella zoster virus (VZV) DNA in 10, and immunoglobulin G antibody to VZV in 10. These changes were more common in patients with acute complications, although they did not predict development of postherpetic neuralgia (PHN). In 9/16 patients (56%), MRI lesions attributable to HZ were seen in the brainstem and cervical cord. At 3 months, 5/9 patients (56%) with abnormal MRI had PHN, whereas none of the 7 patients with no HZ-related lesions on MRI had any remaining pain. Subclinical extension of viral inflammation into the CNS occurs commonly in HZ. This finding may have implications for treatment of HZ and prevention of various associated complications. |
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brainstem,lesion of cerebrospinal fluid cerebrospinal fluid,abnormal cerebrospinal fluid,elevated protein of herpes zoster MRI MRI,abnormal pleocytosis of cerebrospinal fluid polymerase chain reaction pons,lesion of rash skin,lesions in neurologic disorders spinal cord,lesion of viral infection
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