Abdominal wall protrusion following herpes zoster

Junior, Facundo Ruiz; Shinosaki, Jullyanna Sabrysna Morais; Marques, Wilson; Ferreira, Marcelo Simão

doi:10.1590/s0037-86822007000200018

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…In 1885, Taylor [15] reported the first known case of a patient with a segmental zoster abdominal paresis. Since that time, other similar cases have been described [10‐13,15‐45]. The aim of this article was to review the existing literature with regard to this specific complication and to summarize the findings from the published evidence.…”

Section: Introductionmentioning

confidence: 93%

Segmental Zoster Abdominal Paresis (Zoster Pseudohernia): A Review of the Literature

Chernev

Dado

2013

PM&R

117

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Herpes zoster is a distinct clinical syndrome that may present with a segmental zoster paresis. Although thoracic dermatomes are the most commonly affected, paresis of the abdominal muscles has been less frequently reported. To review the existing published evidence regarding this unusual clinical entity, a literature search of PubMed and Google was performed. In total, 35 articles that described 36 individual cases were identified. The information from all the cases was tabulated for the analysis. The mean age was 67.5 years. The ratio of men to women was approximately 4:1. The left and right side were approximately equally affected. The most affected associated dermatome was T11. In 88.9% of the patients, the typical herpetic rash preceded the abdominal weakness. The mean latent period from rash to onset of abdominal muscle weakness was 3.5 weeks. Electrodiagnostic studies confirmed the diagnosis in 95% of the tested patients. Complete recovery with conservative measures occurred in 79.3% of the patients who were followed-up for recovery, with a mean time for recovery of 4.9 months. Visceral neuropathy co-occurred in 19.4% of the patients. Because of its self-limited nature and good prognosis, recognition of this complication is important to prevent unnecessary diagnostic studies and procedures. Electrodiagnostic studies can be effectively used to confirm the diagnosis. Because visceral neuropathy commonly co-occurs with segmental zoster abdominal paresis, it should be actively investigated and treated.

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Section: Introductionmentioning

confidence: 93%

Segmental Zoster Abdominal Paresis (Zoster Pseudohernia): A Review of the Literature

Chernev

Dado

2013

PM&R

117

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“…The differential diagnosis includes diabetes, intercostal Segmental abdominal paresis is a rare post-herpetic complication that affects the myotome corresponding to the dermatomal rash distribution. Abdominal wall weakness with flank protrusion mimicking hernia has been described in few case reports, and had benign evolution, with complete resolution in three months to one year [3][4][5][6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…EMG examination made possible to confirm acute axonotmesis in motor fibres [3][4][5]7,9,13]. Denervation activity at rest and loss of motor unit potentials in the left external oblique muscle explained the paresis of abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

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Herpes zoster-induced abdominal wall paresis: Neurophysiological examination in this unusual complication

Santiago-Pérez

Nevado-Estévez

Pérez-Conde

2012

Journal of the Neurological Sciences

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“…If motor nerves are also concurrently involved, symptoms of SZP, including localized, asymmetric myasthenia, may occur, with the myasthenia generally ranging in agreement with the distribution of myomere with skin rashes. In clinical practice, the most commonly affected area is the face (namely, Ramsay-Hunt symptom), followed by limbs (12). The involvement of motor nerves generally occurs within 1 -8 weeks after the appearance of skin lesions.…”

Section: Vzv Infection and Complicationsmentioning

confidence: 99%

Segmental Zoster Paresis: A Literature Review

et al. 2021

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Background: Herpes zoster is an acute infectious skin disease that is induced by the re-activation of the virus incubated in nerve ganglions following initial infection with varicella-zoster virus in childhood. Herpes zoster mainly affects sensory nerves, resulting in severe acute pain, which is also the most common reason for medical intervention in this patient group. The concurrent involvement of motor nerves could induce the symptoms of segmental zoster paresis, which is manifested by localized asymmetric myasthenia, whose range generally follows the distribution of myomere with skin rashes. Due to the low incidence and unspecific clinical manifestations, segmental zoster paresis has not been sufficiently recognized by clinicians, and can easily be misdiagnosed. Objective: To summarize the previous studies on segmental zoster paresis and analyze the pathogeneses, diagnosis, and treatment of this disease, as well as stress the challenges in current treatment, which could provide useful evidence for the clinical diagnosis and better the treatment of patients with segmental zoster paresis in the future. Study Design: We conducted a narrative review. Setting: Hospitals, neurology departments, pain departments, and private practices. Methods: We searched PubMed and Chinese CNKI libraries using the terms “herpes zoster,” “muscle paresis,” “segmental zoster paresis,” and “motor nerve.” Clinical trials, reviews, and case reports were collected and reviewed. Results: As a rare complication following varicella-zoster virus infection, segmental zoster paresis has not been sufficiently recognized by clinicians, and there are still no guidelines available to guide the clinical treatments. The exact mechanism of segmental zoster paresis is still unclear. Electromyographic and magnetic resonance imaging examinations could be used as auxiliary diagnostic methods for segmental zoster paresis. Early regular anti-viral therapy could substantially decrease the risk of herpes zoster related complications. Combined application of glucocorticoids and some other physical therapy may also be useful in certain patients. The general prognosis of segmental zoster paresis is relatively good, with 67% patients achieving complete or almost complete recovery of the muscle function. Limitations: More clinical trials are needed to clarify the exact mechanisms and best treating methods. Conclusion: As the symptom in most segmental zoster paresis patients is self-limited, and the patients’ prognosis is generally good, early diagnosis of the disease is especially important, due to the avoidance of unnecessary diagnostic procedures and incorrect treatments. Standard treatment guidelines regarding the functional rehabilitation are still needed for patients with refractory segmental zoster paresis. Key words: Herpes zoster, postherpetic neuralgia, segmental zoster paresis, muscle strength, motor nerve, spinal dorsal ganglion, zoster infection, muscle paresis

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Abdominal wall protrusion following herpes zoster

Abstract: We present the case of a 62-year-old

Cited by 12 publications

References 9 publications

Segmental Zoster Abdominal Paresis (Zoster Pseudohernia): A Review of the Literature

Segmental Zoster Abdominal Paresis (Zoster Pseudohernia): A Review of the Literature

Herpes zoster-induced abdominal wall paresis: Neurophysiological examination in this unusual complication

Segmental Zoster Paresis: A Literature Review

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