Cranial Ganglia Research Articles

Neural crest lineage in the protovertebrate model Ciona.

Neural crest cells are multipotent progenitors that produce defining features of vertebrates such as the 'new head'1. Here we use the tunicate, Ciona, to explore the evolutionary origins of neural crest since this invertebrate chordate is among the closest living relatives of vertebrates2-4. Previous studies identified two potential neural crest cell types in Ciona, sensory pigment cells and bipolar tail neurons5,6. Recent findings suggest that bipolartail neurons are homologous to cranial sensory ganglia rather than derivatives of neural crest7,8. Here we show that the pigment cell lineage also produces neural progenitor cells that form regions of the juvenile nervous system following metamorphosis. Neural progenitors are also a major derivative of neural crest in vertebrates, suggesting that the last common ancestor of tunicates and vertebrates contained a multipotent progenitor population at the neural plate border. It would therefore appear that a key property of neural crest, multipotentiality, preceded the emergence of vertebrates.

Ramsay hunt syndrome: a case report

Ramsay hunt syndrome (RHS) is a neurological condition comprising of complications with varicella zoster virus (VZV) which results in inflammation of geniculate ganglion. In the days to weeks following zoster, various cranial nerve palsies can develop because the varicella-zoster virus is latent in the cranial nerve ganglia. The trigeminal and facial nerves were the most commonly affected by zoster, based on the cranial nerve involvement. Another common impacted nerve was the vestibulocochlear nerve. As VZV is exclusively human pathogen, research on VZV latency is limited to only human ganglia examination. This case report describes about Ramsay Hunt Syndrome induced or also called as Herpes Zoster Oticus caused by Varicella zoster virus. Diagnosis mainly involved laboratory investigations, patient history, treatment data and other relevant information co-related from various literature. A 46-year-old female patient was diagnosed Ramsay hunt syndrome on the basis of clinical findings as right facial palsy, blisters over right pinna, otalgia and right ear erythematous lesions. Patient also exhibited deviation of angle of mouth to left side and unable to close right eye. This was accompanied by elevated erythrocyte sedimentation rate (ESR) exhibiting acute inflammation. Hemoglobin was low and total leukocyte count was high. Following that, corticosteroids and antivirals were prescribed to assist her medical condition. Remission is slow for RHS, hence patient was also advised for rehabilitation therapy to improvise her lower motor neuron facial palsy. Recurrence is possible in long term so it is imperative to initiate early treatment within 72 hours as soon as the symptoms are observed for better patient care.

Molecular Study of Varicella zoster virus in Cerebrospinal Fluid from Stroke Patients of Thi-Qar province.

Varicella zoster virus (VZV) is a type of alpha-herpesvirus that specifically targets the nervous system. The initial infection, typically occurring during childhood, results in varicella (commonly known as chickenpox), after which the virus enters a dormant state in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia throughout the entire neuroaxis. Molecular and genetic studies of viruses are an important tool for virus development and identifying viral treatments to combat the diseases. The aim of the study was to determine the whole ORF4 sequence of the local VZV strains for phylogenetic analysis to determine the variability in the viral sequence. Ten samples of VZV DNA were subjected to the sequencing of the whole ORF4 region following identification using the PCR method. Sequences from five samples have been successfully analyzed. All clinical strains were discovered to possess a genome with a length of 124,884 base pairs. The sequences exhibited the occurrence of two distinct mutations, one being a transversion and the other a transition, with the latter resulting in an alteration of the amino acid. A phylogenetic tree was constructed using the maximum likelihood method based on the sequences of five nucleotide sequences from clinical samples and nine reference VZV strains. The tree displayed the evolutionary distances between these sequences. The analysis of the phylogenetic tree revealed the presence of five primary clades, with four of them originating from India (isolates S1, S2, S4, S5), while S3 exhibited similarity to a strain from the United Kingdom.

Fibroblast growth factor 8 promotes in vitro neurite outgrowth of placode-derived petrosal and nodose ganglia to varying degrees

Fibroblast growth factors (FGFs) are required for the specification and formation of the epibranchial placodes, which give rise to the distal part of the cranial sensory ganglia. However, it remains unclear whether FGFs play a role in regulating the neurite outgrowth of the epibranchial placode-derived ganglia during further development. Previous studies have shown that Fibroblast growth factor 8 (FGF8) promotes neurite outgrowth from the statoacoustic ganglion in vitro. However, these studies did not distinguish between the neural crest- and placode-derived components of the sensory ganglia. In this study, we focused on the petrosal and nodose ganglia as representatives of the epibranchial ganglia and investigated their axonal outgrowth under the influence of FGF8 signaling protein in vitro. To precisely isolate the placode-derived ganglion part, we labeled the placode and its derivatives with enhanced green fluorescent protein (EGFP) through electroporation. The isolated ganglia were then collected for qRT-PCR assay and cultured in a collagen gel with and without FGF8 protein. Our findings revealed that both placode-derived petrosal and nodose ganglia expressed FGFR1 and FGFR2. In culture, FGF8 exerted a neural trophic effect on the axon outgrowth of both ganglia. While the expression levels of FGFR1/2 were similar between the two ganglia, the petrosal ganglion exhibited greater sensitivity to FGF8 compared to the nodose ganglion. This indicates that the placode-derived ganglia have differential responsiveness to FGF8 signaling during axonal extension. Thus, FGF8 is not only required for the early development of the epibranchial placode, as shown in previous studies, but also promotes neurite outgrowth of placode-derived ganglia.

Lipofuscin accumulates in ganglionic neurons in chronic equine dysautonomia.

Lipofuscin is a complex mixture of highly oxidized, cross-linked macromolecules that accumulates in neurons with age and some neurodegenerative diseases. Equine dysautonomia (ED) is a polyneuropathy that mainly affects autonomic and enteric nervous systems, resulting in alimentary tract dysfunction. Our main aim was to determine whether neuronal lipofuscin increased with increasing duration of ED. We investigated the prevalence of lipofuscin in cranial cervical ganglia of horses with acute (AED), subacute (SED), and chronic ED (CED), young controls (of similar age to ED cases), and aged controls (n = 8 per group). We used Schmorl stain for histologic detection of lipofuscin and assessed its accumulation in neurons using image analysis software. The percentage of neurons positive for lipofuscin increased with age in individual groups and all groups combined (p < 0.001). There were fewer positive neurons in AED and SED compared to aged controls (p < 0.001) and more in CED than AED cases (p = 0.042) and young controls (p = 0.012). We found a strong positive correlation between percentage positive neurons and percentage positive area of the neuron containing lipofuscin for combined groups (p < 0.001). Although neuronal lipofuscin increased in cranial cervical ganglion in CED cases, it remains to be determined whether this is a cause or consequence of neuronal degeneration.

Reduced unilateral sweating caused by varicella zoster virus infection: a case report

BackgroundHerpes zoster is an infectious skin disease caused by the reactivation of the varicella zoster virus (VZV), which has been latent in the posterior root ganglia of the spinal cord or cranial ganglia for an extended period. Neurological complications caused by herpes zoster include aseptic meningitis, white matter disease, peripheral motor neuropathy, and Guillain-Barré syndrome. However, reduced unilateral sweating caused by the VZV is very rare.Case PresentationThis article reports the case of a 34-year-old woman who was admitted to our hospital with sore throat, dizziness, and reduced sweating on the left side of her body. Physical examination found herpes lesions on the left upper lip and left external ear canal (scabbed) and reduced sweating on the left side of the body. Head magnetic resonance imaging (MRI) with contrast showed no abnormalities. After a lumbar puncture, the patient was diagnosed with viral meningitis by VZV infection. The electromyographic skin sympathetic reflex indicated damage to the left sympathetic nerve.ConclusionsSecondary unilateral sweating reduction is a rare neurological complication of herpes zoster, caused by damage to the autonomic nervous system. Literature review and comprehensive examination indicated that the reduced unilateral sweating was due to the activation of latent herpes zoster virus in the autonomic ganglia which has damaged the autonomic nervous system. For patients who exhibit acute hemibody sweat reduction, doctors should consider the possibility of secondary autonomic nervous system damage caused by herpes zoster.

Tlx3 mediates neuronal differentiation and proper condensation of the developing trigeminal ganglion

The trigeminal ganglion, the largest of the vertebrate cranial ganglia, is comprised of sensory neurons that relay sensations of pain, touch, and temperature to the brain. These neurons are derived from two embryonic cell types, the neural crest and ectodermal placodes, whose interactions are critical for proper ganglion formation. While the T-cell leukemia homeobox 3 (Tlx3) gene is known to be expressed in placodally-derived sensory neurons and necessary for their differentiation, little was known about Tlx3 expression and/or function in the neural crest-derived component of the developing trigeminal ganglion. By combining lineage labeling with in situ hybridization in the chick embryo, we show that neural crest-derived cells that contribute to the cranial trigeminal ganglion express Tlx3 at a time point that coincides with the onset of ganglion condensation. Importantly, loss of Tlx3 function in vivo diminishes the overall size and abundance of neurons within the trigeminal ganglion. Conversely, ectopic expression of Tlx3 in migrating cranial neural crest results in their premature neuronal differentiation. Taken together, our results demonstrate a critical role for Tlx3 in neural crest-derived cells during chick trigeminal gangliogenesis.

Functional Study of the Role of the Methyl Farnesoate Epoxidase Gene in the Ovarian Development of Macrobrachium nipponense.

Methyl farnesoate epoxidase (MFE) is a gene encoding an enzyme related to the last step of juvenile hormone biosynthesis. Mn-MFE cDNA has a total length of 1695 bp and an open reading frame (ORF) length of 1482 bp, encoding 493 amino acids. Sequence analysis showed that its amino acid sequence has a PPGP hinge, an FGCG structural domain, and other structural domains specific to the P450 family of enzymes. Mn-MFE was most highly expressed in the hepatopancreas, followed by the ovary and gill, weakly expressed in heart and muscle tissue, and barely expressed in the eyestalk and cranial ganglion. Mn-MFE expression remained stable during the larval period, during which it mainly played a critical role in gonadal differentiation. Expression in the ovary was positively correlated and expression in the hepatopancreas was negatively correlated with ovarian development. In situ hybridization (ISH) showed that the signal was expressed in the oocyte, nucleus, cell membrane and follicular cells, and the intensity of expression was strongest at stage O-IV. The knockdown of Mn-MFE resulted in a significantly lower gonadosomatic index and percentage of ovaries past stage O-III compared to the control group. However, no differences were found in the cumulative frequency of molting between the experimental and control groups. Moreover, the analysis of ovarian tissue sections at the end of the experiment showed differences between groups in development speed but not in subcellular structure. These results demonstrate that Mn-MFE promotes the ovarian development of Macrobrachium nipponense adults but has no effect on molting.

Distribution and anti-nociceptive function of endomorphin-1 in the rat cranial sensory ganglia.

Distribution of endomorphin-1 (EM-1) was immunohistochemically investigated in the rat cranial sensory ganglia. Small to medium-sized neurons in the trigeminal (TG), petrosal (PG), and jugular ganglia (JG) expressed EM-1-immunoreactivity. However, EM-1-immunoreactive (-ir) neurons were infrequent in the nodose ganglion. In the brainstem, EM-1-ir varicose fibers were detected in the superficial layer of the medullary dorsal horn and the caudal part of the nucleus tractus solitarius. By trichrome immunofluorescence analysis, approximately 70% of EM-1-ir neurons were also immunoreactive for transient receptor potential vanilloid 1 (TRPV1) in all the examined ganglia. Additionally, 56.8% of EM1-ir TG neurons and approximately 30% of EM-1-ir PG and JG neurons showed calcitonin gene-related peptide (CGRP)-immunoreactivity. By a retrograde tracing method, several TG, PG, and JG neurons innervating the facial and external ear canal skin expressed EM-1-immunoreactivity. However, EM-1-ir neurons innervating the tooth pulp, circumvallate papilla, and pharynx were relatively rare. Thus, EM-1 expression and its coexistence with TRPV1 and CGRP in the cranial sensory neurons may depend on their various peripheral targets. EM1-ir neurons probably project to the superficial layer of the medullary dorsal horn and caudal part of the nucleus tractus solitarius. EM-1 may be involved in nociceptive transmission from the skin.

Molecular cloning and characterization of three carnitine palmitoyltransferase (cpt) isoforms from mud crab (Scylla paramamosain) and their roles in respond to fasting and ambient salinity stress

As rate-limiting enzymes of β-oxidation of fatty acids in mitochondria, the carnitine palmitoyltransferase (CPT) played an important role in regulating energy homeostasis of aquatic animals. However, there was very little research on β-oxidation of fatty acids in crustaceans. In the present study, the full-length cDNA sequences of cpt-1a, cpt-1b and cpt-2 were isolated from the hepatopancreas of Scylla paramamosain, and contained 4206, 5303 and 3486 bp respectively. Sequence analysis showed that the CPT-1A, CPT-1B and CPT-2 encoded proteins with 777, 775 and 672 amino acids respectively, and only the CPT-1A possessed a transmembrane region. In addition, both the CPT-1B and CPT-2 contained conservative functional domains like N-terminal domain and acyltransferases choActase 2, while the CPT-1A lacked. The results of phylogenetic tree indicated that the CPT-1A, CPT-1B and CPT-2 of S. paramamosain gathered together with their corresponding orthologues from crustaceans. The tissue distribution exhibited that the cpt-1a was highly expressed in hepatopancreas, followed by muscle, eyestalk and cranial ganglia, and the muscle, eyestalk and heart were main expressed tissues of cpt-1b. Furthermore, the high expression levels of cpt-2 were mainly detected in hepatopancreas, muscle and heart. The transcriptional levels of cpt-1a, cpt-1b and cpt-2 were significantly up-regulated under chronic low salinity stress. Besides, at the acute low salinity stress condition, the expression levels of cpt-1a, cpt-1b and cpt-2 in hepatopancreas were dramatically increased in 14‰ and 4‰ salinity groups at the 6h and 48h, while the transcriptional levels of cpt-1a, cpt-1b and cpt-2 in muscle were signally up-regulated in 14‰ and 4‰ salinity groups at the 12h and 24h, showing an alternate response pattern. Similarly, the present study found that fasting could markedly increase the expression levels of cpt-1a, cpt-1b and cpt-2 in hepatopancreas and muscle, especially cpt-1a in hepatopancreas as well as cpt-1a and cpt-1b in muscle. The results above indicated that the cpt-1a, cpt-1b and cpt-2 played a crucial part in providing energy for coping with fasting and salinity stress. These results would contribute to enhancing the knowledge of cpt phylogenetic evolution and their roles in energy metabolism of crustaceans.

Disruption of Fuz in mouse embryos generates hypoplastic hindbrain development and reduced cranial nerve ganglia.

The brain and spinal cord formation is initiated in the earliest stages of mammalian pregnancy in a highly organized process known as neurulation. Environmental or genetic interferences can impair neurulation, resulting in clinically significant birth defects known collectively as neural tube defects. The Fuz gene encodes a subunit of the CPLANE complex, a macromolecular planar polarity effector required for ciliogenesis. Ablation of Fuz in mouse embryos results in exencephaly and spina bifida, including dysmorphic craniofacial structures due to defective cilia formation and impaired Sonic Hedgehog signaling. We demonstrate that knocking Fuz out during embryonic mouse development results in a hypoplastic hindbrain phenotype, displaying abnormal rhombomeres with reduced length and width. This phenotype is associated with persistent reduction of ventral neuroepithelial stiffness in a notochord adjacent area at the level of the rhombomere 5. The formation of cranial and paravertebral ganglia is also impaired in these embryos. This study reveals that hypoplastic hindbrain development, identified by abnormal rhombomere morphology and persistent loss of ventral neuroepithelial stiffness, precedes exencephaly in Fuz ablated murine mutants, indicating that the gene Fuz has a critical function sustaining normal neural tube development and neuronal differentiation.

The differences in the anatomy of the thoracolumbar and sacral autonomic outflow are quantitative.

We have re-evaluated the anatomical arguments that underlie the division of the spinal visceral outflow into sympathetic and parasympathetic divisions. Using a systematic literature search, we mapped the location of catecholaminergic neurons throughout the mammalian peripheral nervous system. Subsequently, a narrative method was employed to characterize segment-dependent differences in the location of preganglionic cell bodies and the composition of white and gray rami communicantes. One hundred seventy studies were included in the systematicreview, providinginformation on 389 anatomical structures. Catecholaminergic nerve fibers are present in most spinal and all cranial nerves and ganglia, including those that are known for their parasympathetic function. Along the entire spinal autonomic outflow pathways, proximal and distal catecholaminergic cell bodies are common in the head, thoracic, and abdominal and pelvic region, which invalidates the "short-versus-long preganglionic neuron" argument. Contrary to the classically confined outflow levels T1-L2 and S2-S4, preganglionic neurons have been found in the resulting lumbar gap. Preganglionic cell bodies that are located in the intermediolateral zone of the thoracolumbar spinal cord gradually nest more ventrally within the ventral motor nuclei at the lumbar and sacral levels, and their fibers bypass the white ramus communicans and sympathetic trunk to emerge directly from the spinal roots. Bypassing the sympathetic trunk, therefore, is not exclusive for the sacral outflow. We conclude that the autonomic outflow displays a conserved architecture along the entire spinal axis, and that the perceived differences in the anatomy of the autonomic thoracolumbar and sacral outflow are quantitative.

Clinical profile of herpes zoster in human immunodeficiency virus infected at a rural-based tertiary care center

Background: Due to the reactivation of the varicella-zoster virus, which had lainissed within sensory ganglions, herpes zoster (HZ) is typified by unilateral radicular pain and grouped vesicular eruption that is typically restricted to the dermatome innervated by a single spinal or cranial sensory ganglion. It is widely known that reactivation of varicella-zoster virus infection as HZ can cause morbidity in a human immunodeficiency virus (HIV)-positive host. Aims and Objectives: The aim of this study was to describe the clinical profile of HZ among HIV-positive patients in a rural tertiary care center. Materials and Methods: A prospective hospital-based study was conducted in a rural tertiary care hospital in Karnataka for duration of 24 months. All patients attending the outpatient department (OPD) of dermatology with clinical features of HZ and post-herpetic complications irrespective of their age and gender were included in the study. Data collection done in a semi-structured questionnaire on patient particulars as well as pre-existing co-morbidities was documented. Results: A cross-sectional study included 75 HZ patients attending OPD. Among the total 75 HZ patients, 11 were found to be seropositive for HIV infection. Seroprevalence among HZ was 14.6%. Among seropositive patients, the maximum belonged to the age group 41–60 years (63.3%). In the seropositive group, maximum cases (36.4%) occurred during summer while it was in the post monsoon season (39%) in the seronegative group. Conclusion: It is known that multidermatomal and severe pain is more commonly seen in HIV-infected patients than in the normal population. Many HIV-positive patients can present with a typical presentation of zoster as seen in our study.

Age-dependent patterns of somatostatinergic neurons in sympathetic paravertebral ganglia

Aim. We aimed to determine the content of neurons expressing somatostatin (SST) and their colocalization with cells expressing tyrosine hydroxylase (TH) and neuropeptide Y (NPY) in the cranial cervical ganglion (CCG) and celiac plexus in rats. Material and methods. We used 30 white male Wistar rats of six age groups (5 rats per group): newborn pups, 10-, 20-, 30-, and 60-day-old pups, and 24-month-old pups. We incubated their ganglia sections with primary antibodies against SST, NPY, and TH, as well as with secondary antibodies conjugated with fluorochromes. We evaluated the ratio between immunoreactive (IR) neurons with a visible nucleolus and excessive fluorescence and the total number of neurons, as well as the average cross-sectional area, by ImageJ software (NIH, USA).Results. SST-IR neurons were not found in the CCG. However, the immunoreaction (as granules) was revealed in most perikaryons at the celiac plexus for SST and NPY with a rather homogeneous distribution for TH. The ratio of ST-IR neurons reached 33% in pups, doubled during the first month of life, and then remained constant (70–73%). No statistically significant differences were found between the ratios of SST-IR neurons of the cranial mesenteric ganglion (CMG) and celiac ganglion (CG) for all age groups. From the moment of birth to 60 days of life, the average cross-sectional area of SST-IR neurons in the CG and CMG increased by 3.4–3.9 times and then did not change until 24 months. From the 20th day of life, the average cross-sectional area of SST-IR neurons in the CG was significantly higher than that in the CMG. All SST-IR neurons in all age groups expressed TH, while 90–94% of neurons expressed NPY. Conclusions. The content of ST-IR neurons in different sympathetic nodes is not the same: they are absent in the CCG, and their ratio and area in the celiac plexus increase during early postnatal development. This may be due to the peculiarities of innervated target organs.

Cannabinoid receptor type 1 regulates sequential stages of migration and morphogenesis of neural crest cells and derivatives in chicken and frog embryos.

The main cannabinoid receptor CB1R first shows expression during early neurula stage in chicken (Gallus gallus) embryos, and at early tailbud stage in the frog (Xenopus laevis) embryos. This raises the question of whether CB1R regulates similar or distinct processes during the embryonic development of these two species. Here, we examined whether CB1R influences the migration and morphogenesis of neural crest cells and derivatives in both chicken and frog embryos. Early neurula stage chicken embryos were exposed to arachidonyl-2'-chloroethylamide (ACEA; a CB1R agonist), N-(Piperidin-1-yl)-5-(4-iodophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide (AM251; a CB1R inverse agonist) or Blebbistatin (nonmuscle Myosin II inhibitor) in ovo and examined during migration of neural crest cells and at condensing cranial ganglia stage. Early tailbud stage frog embryos were bathed in ACEA, AM251 or Blebbistatin, and analyzed at late tailbud stage for changes in craniofacial and eye morphogenesis, and in patterning and morphology of melanophores (neural crest-derived pigment cells). In chicken embryos exposed to ACEA and Myosin II inhibitor, cranial neural crest cells migrated erratically from the neural tube, and the right, but not the left, ophthalmic nerve of the trigeminal ganglia was affected in ACEA- and AM251-treated embryos. In frog embryos with inactivation or activation of CB1R, or inhibition of Myosin II, the craniofacial and eye regions were smaller and/or less developed, and the melanophores overlying the posterior midbrain were more dense, and stellate in morphology, than the same tissues and cells in control embryos. This data suggests that despite differences in the time of onset of expression, normal activity of CB1R is required for sequential steps in migration and morphogenesis of neural crest cells and derivatives in both chicken and frog embryos. In addition, CB1R may signal through Myosin II to regulate migration and morphogenesis of neural crest cells and derivatives in chicken and frog embryos.

Effects of dietary trimetlylamine oxide on the growth performance, feed utilization and appetite regulation of Chinese mitten crab (Eriocheir sinensis)

A 60-day feeding trial was conducted to evaluate the effects of different TMAO (trimetlylamine oxide) supplement levels (0%, 0.12%, 0.24%, and 0.48%, named G1, G2, G3, and G4, respectively) on growth performance, feed utilization, intestinal enzyme activities and appetite regulation of Eriocheir sinensis. The results showed that diet supplemented with 0.24% trimetlylamine oxide (TMAO) significantly improved the weight gain rate (WGR), specific growth rate (SGR), feed intake (FI) and feed utilization (p < 0.05), while having no effect on the survival rate (SR) and molting frequency (MF) of crabs (p > 0.05). Moreover, moderate dietary TMAO levels significantly improved the intestinal enzyme activities (α-amylase, trypsin, lipase and γ-glutamyl transferase) of crabs. The RT-qPCR results showed that the expressions of the orexigenic neural signal-related factors neuropeptide Y (npy) and ghrelin were significantly up-regulated. The expressions of AKT/TOR/4E-BP signaling pathway related genes (protein kinase B (akt), target of rapamycin (tor) and 4E-binding protein (4e-bp)), anorexia-regulating peripheral hormones (leptin and cholecystokinin (cck)) and leptin receptor (lepr) were significantly down-regulated in the hepatopancreas, thoracic ganglia and cranial ganglia tissues. The anorexigenic neural signal-related factors cocaine and amphetamine regulated transcript (cart) and pro-opiomelanocortin (pomc) were significantly down-regulated in the hepatopancreas, thoracic ganglia and cranial ganglia tissues. Based on the quadratic regression analysis of WGR against dietary TMAO level, the optimum TMAO requirement of E. sinensis was suggested to be 0.27%. In conclusion, present results suggested that dietary supplementation with 0.27% TMAO can improve the growth performance, feed intake, intestinal enzyme activities and appetite regulation of E. sinensis.

Peripheral nervous system involvement in SARS-CoV-2 infection: a review of the current pediatric literature.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the pathogen responsible for the pandemic health emergency declared by the World Health Organization in March 2020. During the first part of the pandemic, adults showed mild to severe respiratory symptoms. Children seemed initially exempt, both from acute and subsequent complications. Hyposmia or anosmia were promptly identified as the main symptoms of acute infection, so neurotropism of SARS-CoV-2 was immediately suspected. (1, 2). As the emergency progressed, post infectious neurological complications were described also in pediatric population (3). Cases of cranial neuropathy in connection with acute SARS-CoV-2 infection have been reported in pediatric patients, as an isolate post infectious complication or in the context of the multisystem inflammatory syndrome in children (MIS-C) (4-6). Neuroinflammation is thought to be caused by several mechanisms, among which immune/autoimmune reactions (7), but so far, no specific autoantibody has been identified. SARS-CoV-2 can enter the central nervous system (CNS) directly and/or infect it retrogradely, through the peripheral nervous system (PNS), after replicating peripherally; several factors regulate invasion and subsequent neuroinflammation. Indeed, direct/secondary entry and replication can activate CNS-resident immune cells that, together with peripheral leukocytes, induce an immune response and promote neuroinflammation. In addition, as we will discuss in the following review, many cases of peripheral neuropathy (cranial and non-cranial) have been reported during or after SARS-CoV-2 infection. However, some authors have pointed out that the increase of cranial roots and ganglia in neurological imaging is not always observed in children with cranial neuropathy. (8). Even if a variety of case reports were published, opinions about an increased incidence of such neurologic diseases, linked to SARS-CoV-2 infection, are still controversial (9-11). Facial nerve palsy, ocular movements abnormalities and vestibular alterations are among the most reported issues in pediatric population (3-5). Moreover, an increased screen exposure imposed by social distancing led to acute oculomotion's disturbance in children, not primarily caused by neuritis (12, 13). The aim of this review is to suggest food for thought on the role of SARS-CoV-2 in neurological conditions, affecting the peripheral nervous system to optimize the management and care of pediatric patients.

The Neuroanatomical Basis of Unfamiliar Presentations of Herpes Zoster: A Review and A Case Report

Herpes zoster (HZ, shingles) is caused by reactivated varicella zoster virus, that travels along the peripheral branches from its dormant location in neurons of spinal and cranial sensory ganglia. HZ is well known for its skin vesicular eruptions and severe sensory neuropathy. Over the years, reports have described the occurrence of segmental paresis of skeletal muscles and the involvement of the large and small intestine, clinically resembling intestinal obstruction.

RESEARCH ON CLINICAL MANIFESTATIONS, CORRELATIVE FACTORS AND EVALUATING THE RESULTS OF TOPICAL TREATMENT OF ZONA WITH HE-NE LASER COMBINATION AT CAN THO DERMATO-VENEREOLOGY HOSPITAL IN 2021

Background: Shingles is a common skin infection, caused by the latent Varicella zoster virus in the paraspinal cranial nerve ganglia, when there are favorable factors such as immunosuppression makes the virus active again. The disease greatly affects the patient's quality of life. Objectives: Survey to determine clinical manifestations, correlative factors and evaluate the results of topical treatment of herpes zoster with He-Ne laser combination at Can Tho DermatoVenereology Hospital in 2021. Methods: Cross-sectional descriptive study with 75 Zona patients who were treated according to the usual regimen and combined with local He-Ne laser at Can Tho Dermato-Venereology Hospital. Results: The disease that occurs in the age group over 60 years old is the most common (56%). Pain was found in 100% of patients. The vesicle lesions accounted for the highest rate (84%), the most commonly affected area was trunk 38.7%. Mild level accounted for 57.3%. The group of patients with more than 5 days of illness had a longer hospital stay (42.9%). After treatment with He-Ne laser, 66.7% had good treatment results. Conclusions: Herpes zoster disease occurs at any age, but mainly in the elderly with vesicles and pain in most of the patients, commonly on the trunk and head-face-neck area. Attention should be paid to the time before admission, the state of co-infection because they reduce the response to treatment. The combination of He-Ne laser with conventional regimens helped to cure and effectively reduce pain in Herpes Zoster patients.

Ensefalit Kliniği ile Başvuran Hastada Oftalmik Zona ve COVID-19 Beraberliği

Varicella zoster virus (VZV) is a member of the herpes virus family and is the causative agent of chickenpox and shingles. While chickenpox, which is the primary infection, is mostly seen in childhood, shingles is located latently in the dorsal root sensory ganglia and cranial nerve ganglia, causing recurrent attacks in adulthood. Shingles may rarely present with neurological complications such as encephalitis. Many diseases are seen in the coexistence of Coronavirus disease-2019 (COVID-19) due to the pandemic. In this case report, it was aimed to draw attention to the ophthalmic varicella zoster virus infection with a different clinical onset accompanied by COVID-19 who presented with the clinic of encephalitis.