Varicella-Zoster Virus Myelitis: MRI Diagnosis, CT Imaging, Emergency Radiology Pearls & Rare Spinal Cord Findings
Varicella-Zoster Virus Myelitis: MRI Diagnosis, CT Imaging Findings, Differential Diagnosis, and Emergency Radiology Interpretation Introduction A 74-year-old woman arrives at the emergency department with an unusual complaint. Over the past two weeks, she has experienced progressively worsening numbness in both lower extremities. She has metastatic breast cancer but has remained neurologically stable until recently. During the physical examination, clinicians notice something that immediately changes the diagnostic direction—a painful, linear vesicular rash extending from the right buttock to the foot. Could this be spinal metastasis? Acute spinal cord infarction? Multiple sclerosis? Or something much rarer? The answer lies in one of the most fascinating yet easily overlooked neurological complications of Varicella-Zoster Virus (VZV) — Varicella-Zoster Virus Myelitis . Although herpes zoster ("shingles") is common worldwide, spinal cord involvement occurs in only a tiny fr...