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Shingles underlies many infections in the brain

14th June 2013


Shingles, which is caused by the chickenpox virus, can be an underestimated cause of infection in the brain. Long after the infection, patients may also develop problems with memory and other cognitive problems.

These are two of the findings in a dissertation from the Sahlgrenska Academy, Sweden.
In Sweden alone, varicella virus may underlie between 150 and 200 cases of infection of the brain each year. This is the finding of a dissertation that studied the incidence of brain infections in a Western region of Sweden.


“There has been an assumption among physicians that the chickenpox virus could not be a particularly common cause of infections in the brain, but we now show that one should suspect the chickenpox virus in patients with various types of brain infection,” says doctoral student Anna Grahn at the Sahlgrenska Academy, University of Gothenburg.


She studied 121 patients who sought treatment for meningitis, encephalitis, stroke, or single-sided facial paralysis, and who were found to have chickenpox virus in the spinal fluid. A specific analysis of the spinal fluid in 24 patients showed signs of neuronal damage associated with infection. This was particularly evident for patients who had had encephalitis.


Three years after the brain infection, 14 of the patients underwent neuropsychological tests, which showed that several had a persistent cognitive impairment.
“They could not think as fast, could have problems with attention and the ability to perform complex tasks, and had an impaired memory compared to the healthy control group Crown,” says Anna Grahn.
To date, no controlled treatment studies have been performed with these patients.


“Considering how many people get serious brain damage from shingles, it is important that these patients receive the right treatment and the right follow-up to prevent neurological sequelae. We need to explore better what the right treatment is for these patients” says Anna Grahn.
In several countries such as USA and Germany, and soon even Finland, chickenpox is included in the general childhood vaccination program.


“There are also discussions in Sweden to add chicken pox vaccine to the national infant immunization program. In addition, a vaccine against shingles will soon be introduced in Sweden. Vaccination will hopefully reduce the number of neurological complications. This dissertation contributes additional knowledge,” says Anna Grahn.


FACTS ABOUT CHICKENPOX

Chickenpox is regarded as a harmless disease that causes fever, rash and blisters. Almost everyone gets chickenpox as a child, and it rarely requires treatment at that time. After the initial infection, chickenpox virus resides in ganglia along the spine and in the brain, and later might cause the disease shingles. Both shingles and chickenpox can lead to neurological complications such as encephalitis, meningitis, half-sided facial paralysis and stroke.

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