Objective: To report myoclonus and other movements disorders complicating chickenpox.

Background: The meningoencephalitis is a rare complication of chickenpox. The occurrence of movements disorders is an exceptional clinical expression, whose pathophysiology still not well understood.

Methods: Observation: We report the case of 17 years old boy without medical history who presented 3 days after chickenpox abnormal involuntary movements such as myoclonus and spasms of the face, trunk, neck and extremities of the upper limbs. A neurological examination showed no deficit or ataxia. CT scan was normal. Cerebrospinal fluid (CSF) analysis revealed 95 leukocytes/mm3 and protein concentration of 72 mg/dl. The rest of biological and immunological tests were normal. He was treated with IV acyclovir (1800 mg/day for 21 days) and methylprednisolone pulse therapy followed by oral prednisolone (50 mg/day for 21 days and thereafter gradually decreased) and symptomatic treatment by Clobazam. The evolution was marked by the complete disappearance of movements disorders. One month later the patient has represented truncal myoclonus. CSF examination revealed high protein and normal leukocytes count. The brain magnetic resonance imaging showed no abnormalities. The patient was treated with combined acyclovir/steroid treatment with a good improvement of his symptoms. At 8 months follow-up the patient was asymptomatic.

Results: Discussion: The occurrence of abnormal movements may be part of chickenpox encephalitis which can be explained either by post infectious perivenous demyelination or by intracerebral propagating virus. Varicella zoster virus can reactivate in the absence of skin rash which may explain the recurrence of movements disorders in our patient a month of the initial treatment.

Conclusions: Neurological complications of chikenpox may occur despite the availability of an effective vaccine. In these cases combined acyclovir/steroid treatment is recommended in association with symptomatic treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/myoclonus-complicating-chickenpox-a-case-report/