Zoster sine herpete

Varicella zoster virus (VZV) is an exclusively human neurotropic herpesvirus that causes varicella (chickenpox) during primary infection, after which the virus becomes latent in cranial nerve, dorsal root, and autonomic ganglia along the entire neuraxis. 1 Decades later, virus may reactivate to cause herpes zoster (shingles), an extremely painful vesicular skin rash confined to one or more sensory dermatomes. 2 The incidence of zoster is increased in elderly and immunosuppressed individuals. The most important complication of zoster is postherpetic neuralgia, severe dermatomal pain that is long-lasting and refractory to treatment, and is most common in zoster patients over the age of 50 years. 1 VZV reactivation can also lead to multiple other neurologic and ocular disorders, including vasculopathy, myelopathy, the Ramsay Hunt syndrome, meningoencephalitis, polyneuritis cranialis, cerebellitis, and necrotizing retinitis. 2