Background   Varicella-zoster virus infection-related myelitis (VZVM) is a relatively rare complication in central nervous system after herpes zoster virus infection. There are few studies on VZVM so far, with most of them being case reports.

  Objective   To explore the clinical features and prognosis of VZVM, so as to improve the understandings of VZVM in clinicians.

  Methods   From June 2009 to January 2020, the clinical characteristics and imaging data of 18 patients with VZVM discharged from neurology department of the First Medical Centre of Chinese PLA General Hospital were collected and analyzed.

  Results   Of the 18 patients, there were 10 males and 8 females, aged 57.83 ± 12.62 (range, 36-80) years. Sixteen patients developed myelitis after the rash's initiation, while two patients developed myelitis firstly. The average interval between rash and myelitis was (21.22 ± 18.40) days. And patients complained worst symptom within (12.72 ± 8.99) days in average. Rash located in cervical dermatomes in 9 cases, thoracic dermatomes in 10 cases, and lumbar dermatomes in 2 cases. Most of the abnormal signals were detected in cervical dermatomes, and posterior horn was more commonly involved detected by MR scanning. Four patients met the 2015 diagnostic criteria for neuromyelitis optical spectrum disease. One patient showed positive result on VZV-DNA test. During the follow-up of 42.2 months, Expanded Disability Status Scale score deceased from 5.67 to 3.61. Some patients were treated with a variety of combined treatment, nevertheless, remnant neurological defect happened after the management. Two patients relapsed.

  Conclusion   VZVM mainly occurs in the elderly. The cervical and thoracic dermatomes were most commonly involved, which is correlated with the onset time and spinal cord segments of myelitis. Glucocorticosteroid and antiviral drugs treatment may be effective. A small number of patients may be complicated with NMOSD or may relapse.