Positive PCR of varicella tester in the CSF of two patients with multiple sclerosis

Two patients with primary manifestation of relapsing remitting multiple sclerosis had positive oligoclonal-bands in the cerebrospinal fluid (CSF), electrophysiologically confirmed multifocal demyelinating lesions, pathologic MRT imaging with multiple periventricular gadolinium-enhancing cerebral lesions but only a partial synthesis of antibodies against measles, rubella, and varicella zoster viruses in the CSF (case 1: measles 2.0, rubella 1.7,case 2: measles 1.9). On the other hand, we detected a positive VZV-PCR for varicella zoster in CSF by PCR technique without any clinical symptoms or other laboratory findings of an infection by varicella tester viruses. Antiviral therapy was ineffective. We therefore conclude, that a positive PCR in the CSF increases the difficulty of diagnosing multiple sclerosis and should only been taken into therapeutical consideration if clinical symptoms and other laboratory findings are present.