Cerebrospinal fluid biomarkers in facial nerve palsy caused by Varicella Zoster virus

Abstract

No: 1680 Presentation at ESCV 2015: Poster 1 Cerebrospinal fluid biomarkers in facial nerve palsy caused by Varicella Zoster virus J. Lindstrom1,∗, A. Grahn1, H. Zetterberg2, M. Studahl1 1 Department of Infectious Diseases, Sahlgrenska University Hospital, Ostra, Goteborg, Sweden 2 Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sweden Background: Reactivation of Varicella Zoster virus (VZV) can cause facial nerve palsy with neurological sequels despite treatment with aciclovir and/or corticosteroids. Associated symptoms such as vertigo and loss of hearing are frequent. Facial nerve palsy caused by VZV manifest as Ramsay Hunt syndrome when blisters are present, or as zoster sine herpete without blisters. Neurofilament light protein (NFL), glial fibrillary acidic protein (GFAp) and S-100 are cerebrospinal fluid (CSF) biomarkers that have been used to estimate severity of neuronal damage and prognosis in various CNS diseases. One previous study has been performed on VZV in the central nervous system (CNS), but patients with facial palsy have not been specifically studied. Methods: 28 patientswith VZV facial palsy, diagnosed by detection of VZV DNA in CSF by PCR, were retrospectively identified. GFAp, NFL and S-100 were measured in stored CSF samples and compared with a control group (n=52). Medical records were studied for relevant patient data such as severity of symptoms, treatment and laboratory parameters. Results: CSF concentrations of NFL and GFAp were significantly elevated compared to controls (p<0.01 and p<0.05) and S-100 concentrations were reduced. Additionally, NFL kinetics indicated slightly increasing concentrations in CSF samples drawn more than seven days after onset of neurological symptoms. Viral load (VZV DNA copies/ml) correlated with both NFL (Spearman r=0.51; p<0.01) and GFAp (Spearman r=0.54; p<0.01). No correlations were found between biomarkers and severity of symptoms, clinical outcome at follow-up, or treatment with aciclovir prior to CSF sampling in this small study. Conclusion: In this first study on biomarkers in facial palsy caused by VZV, we identified a pattern of elevated NFL, elevated GFAp and decreased S-100 compared to controls. Increased NFL levels reflect axonal damage, and elevated levels of GFAp, in combination with decreased concentrations of S-100 , indicate astrogliosis rather than damage to the astroglial cell membrane. Biomarkers of neuron and glial cell damage can be used to understand pathogenesis, and in future studies assessment of these biomarkers in relation to treatment and clinical outcome should be explored. http://dx.doi.org/10.1016/j.jcv.2015.07.137 Abstract No: 1682 Presentation at ESCV 2015: Poster 1 False negative influenza A virus subtype H3N2 in Prodesse GenProbe ProFlu+ PCR assay in season 2014–2015 N. Kirkby1,∗, T.N. Thomsen1, R. Trebbien2, K. Vorborg2, J. Ronn2, T.K. Fischer2, C.B. Christiansen1 1 Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark 2 National Influenza Center, Virological Surveillance and Research Department of Microbiological