A case of an 18-month-old girl who developed a right hemiplegia 10 days after onset of varicella infection is reported from the Division of Pediatric Neurology, Istanbul University, Turkey. The child was admitted with hemiparesis following a focal clonic seizure involving the arm and leg. She was afebrile and had healed varicella lesions on the trunk. CT and MRI showed infarction of the left putamen and internal capsule. MR angiography was normal. A mild hemiparesis had persisted at 7-month follow-up. [1]
COMMENT. The authors’ review of the literature cites 21 previous reports of hemiparesis and infarct following varicella in children. The interval between the rash and hemiparesis was 10 days to 4 months (mean 9 weeks). EEGs showed focal abnormalities in one half the cases. Angiography had revealed arterial stenoses involving the middle cerebral. Occasional cases of hemiparesis presented before the rash appeared. Pre-eruptive varicella encephalitis with cerebellar ataxia is also reported in a child treated at the Mayo Clinic. [2]