—Dr Liu is correct: we missed earlier reports on the association between chickenpox and acute hemiparesis in childhood. Recently, another case was described by Shuper et al.1 This 7.5-year-old boy developed a right hemiplegia and aphasia 10 weeks after contracting chickenpox. He presented again 7 months later with an acute exacerbation of seizures. Cerebral angiography showed evidence of focal vasculitis.The presumed association of primary varicella zoster virus infection and vasculitis rests on the temporal occurrence and on the demonstration of an intrathecal varicella zoster virus-specific IgG response. However, oligoclonal bands can still be demonstrated several months after an uncomplicated varicella zoster virus meningitis and do not provide definite evidence for active infection.2 Definite proof of the linkage between primary varicella zoster virus infection and vasculitis can only be obtained by cerebral biopsy, which is not indicated in these patients, or by an autopsy.In clinical
Peters ACB. Delayed Varicella Vasculopathy-Reply. Arch Neurol. 1991;48(9):900. doi:10.1001/archneur.1991.00530210026014
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