Comparative Study of Cerebrospinal Fluid and Serological Data from Patients with Vestibular Neuronitis and Herpes Zoster

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Cerebrospinal fluid (CSF) was collected from seven patients with vestibular neuronitis and from seven with herpes zoster for immunological studies. Serological studies were conducted simultaneously. The patients with vestibular neuronitis were four males and three females, aged 28 to 55 years and those with herpes zoster were four males and three females aged 17 to 73 years. They were all observed for over three months. All CSF samples obtained by lumbar puncture were examined for total protein, albumin, IgG, IgA, IgM, cell count and various virus antibody titers (herpes simplex 1, varicella-zoster, cytomegalo, EB, rubeola, parainfluenza types 1-3, influenza A and B, rubella and Japanese encephalitis).1) The CSF in all seven cases of vestibular neuronitis showed a quite high protein content, increasing about two weeks after the onset; the cell count remained normal throughout the clinical course.2) The CSF/serum albumin index (CSF x 103/ serum albumin concentration ratio) and IgG index [(CSF/serum IgG)/(CSF/serum albumin)] were calculated. In vestibular neuronitis both of these indices were within the normal range and there was no significant change throughout the clinical course.3) Herpes simplex virus (HSV) type 1 IgG antibody titer in paired sera rose in one of the seven cases of vestibular neuronitis, but the antibody titer of the same virus in the CSF was not detected.4) Either HSV type 1 IgG or EB virus capsid antigen (EBV·CA) IgG antibody titer (FA) in the CSF was elevated in five cases of vestibular neuronitis.5) In the five cases of vestibular neuronitis the ratio of the CSF antibody titer to the serum was 1:160 for HSV IgG (FA), and≤1:80 for EBV·CA IgG (FA).6) In six of the seven cases of herpes zoster the CSF protein content rose slightly within a week after onset and then fell to the normal range during the clinical course.7) In the herpes zoster cases the CSF/serum albumin indices were all normal, while the IgG index was elevated in the two cases with lymphocytic pleocytosis in the CSF.8) In herpes zoster, varicella-zoster virus (VZV) IgG (FA) in the CSF was significantly elevated in the two cases with lymphocytic pleocytosis in the CSF.9) Either HSV IgG or EBV·CA IgG antibody titer (FA) in the CSF was elevated in four cases of herpes zoster.10) In the four cases of herpes zoster the ratio of the CSF antibody titer to the serum was 1:160 for HSV IgG (FA), and 1:160 to 1:320 for EBV·CA IgG (FA).
耳鼻咽喉科臨床学会の論文

Comparative Study of Cerebrospinal Fluid and Serological Data from Patients with Vestibular Neuronitis and Herpes Zoster

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