Herpes Zoster Encephalitis 2 Case Reports and Review of Literature

Herpes zoster encephalitis (HZE) is a rare complication of varicella-zoster virus infection. Because of its nonspecific clinical presentation, HZE is underrecognized. The advent of polymerase chain reaction for detecting viral particles in cerebrospinal fluid provides a rapid and accurate means of diagnosis. Two patients with HZE diagnosed by a positive cerebrospinal fluid-polymerase chain reaction and neurological changes are presented, and the literature is reviewed. We provide a practical approach to the diagnosis and treatment of HZE and conclude that HZE is underdiagnosed and should be considered in all patients with encephalitis even in the absence of a herpes zoster rash.