Segmental Zoster Paresis of the Upper Extremity: A Case Report

Yoleri, Özlem; Ölmez, Neşe; Öztura, İbrahim; Şengül, İlker; Günaydın, Rezzan; Memiş, Asuman

doi:10.1016/j.apmr.2004.09.032

Cited by 51 publications

(59 citation statements)

References 13 publications

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“…Literature shows that use of antivirals at appropriate doses can prevent motor involvement, and use of steroids can also be effective in such cases. Some publications recommend use of iv acyclovir and iv steroids in case of paresis [1,6]. We didn't prefer iv steroids due to presence of diabetes mellitus in our patient.…”

Section: Discussionmentioning

confidence: 95%

“…Based on these results, motor paralysis might have been related with an inflammatory process. In 2005, Yoleri et al [6] reported a case who developed muscle weakness in the shoulder girdle associated with involvement of the C5-7 motor roots and upper truncus of the brachial plexus secondary to herpes zoster. In 2006, Eyigor et al [7] described a 54-year-old male patient with monoparesis, hyperalgesia, allodynia, edema, and both color and skin-temperature changes, who was diagnosed with complex regional pain syndrome and brachial plexopathy secondary to herpes zoster.…”

Section: Discussionmentioning

confidence: 99%

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Acute monoplegia secondary to herpes zoster infection: a case report

Aksoy

Altan

Solum

2017

The European Research Journal

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Brachial plexopathy with motor involvement secondary to herpes zoster infection is very rare. Also known as shingles, herpes zoster occurs as a result of reactivation of varicella zoster virus in the dorsal root ganglia. We present a 69-year-old male patient with right upper extremity monoplegia secondary to herpes zoster infection. Physical examination showed scars from rash on his right antecubital fossa. Electroneuromyography showed a low amplitude motor response of the right median nerve, while having no sensation response at digits 1 and 3. Right ulnar and radial nerve sensation responses were lower in amplitude compared to the left side. Herpes zoster should be considered in the differential diagnosis of acute monoparesis. It is very important in avoiding unnecessary tests and treatments.Eur Res J 2017;3(1):90-93

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Acute monoplegia secondary to herpes zoster infection: a case report

Aksoy

Altan

Solum

2017

The European Research Journal

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“…Based on the association between the involved myotome and the dermatome of the rash, viral spread from the dorsal root ganglion to the anterior horn cells or anterior spinal nerve roots, resulting in inflammation and motor paresis, is suspected. 2,9 According to Hanakawa et al, the inflammation causes a neurological deficit by producing hypervascularity in the perineural structures or actual disruption of the blood-nerve barrier.…”

Section: Discussionmentioning

confidence: 99%

“…The commonly involved nerve segments are thoracic, lumbar and trigeminal. 1,2 It may also spread to involve the nerve roots adjacent to the dorsal root ganglia causing a plexitis or neuritis. 3,4 Postherpetic neuralgia is the most common complication of HZ affecting more than 40% of patients.…”

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confidence: 99%

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Segmental Limb Paresis Due to Zoster Plexopathy: Case Report

Arslan¹,

Uyaroğlu²,

Öcek³

et al. 2016

Turkiye Klinikleri J Neur

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68erpes zoster (HZ) is the reactivation of dormant varicella zoster virus (VZV) in the dorsal root ganglia. The commonly involved nerve segments are thoracic, lumbar and trigeminal.1,2 It may also spread to involve the nerve roots adjacent to the dorsal root ganglia causing a plexitis or neuritis.3,4 Postherpetic neuralgia is the most common complication of HZ affecting more than 40% of patients. In contrast, the motor complications of herpes zoster are rare and their true incidence is unknown. Review of the literature suggests that motor involvement occur between 1-Segmental Limb Paresis Due to Zoster Plexopathy: Case Report A AB BS S T TR RA AC CT T Segmental zoster paresis (SZP) is focal, asymmetric and a rare cause of neurogenic weakness that may occur in a limb caused by herpes zoster (HZ). It typically occurs 2-3 weeks after the herpetic rash and usually affects the myotome that corresponds to the dermatomal distribution. HZ plexopathy may be overlooked in the acute period, or the motor paresis may be mistakenly diagnosed as another cervical or lumbar pathology after the vesicular lesions have disappeared. Three zoster plexopathy cases; two brachial and one lumbar were presented in this article. Electrophysiological study (EDX) findings, limb paresis, pain and erupted skin lesions with positive VZV antibodies indicated HZ plexopathy. EDX revealed patchy involvement of brachial and lumbar plexus. Antiviral treatment and physiotherapy improved muscle strength to mild paresis. An accurate and early diagnosis is vital for total recovery of muscle strength.K Ke ey y W Wo or rd ds s: : Brachial plexus neuropathies; electromyography; herpes zoster; acyclovir; sacral plexopathy Ö ÖZ ZE ET T Segmenter zoster parezisi (SZP) fokal, asimetrik, herpes zoster (HZ) nedeniyle tek ekstremitede oluşabilen nadir bir nörojenik güçsüzlüktür. Tipik olarak herpetik döküntüden 2-3 hafta sonra meydana gelir ve genellikle dermatomal dağılıma karşılık gelen miyotomu etkiler. HZ pleksopati akut dönemde gözden kaçabilir veya lezyonlar kaybolduktan sonra motor pareziye yanlışlıkla diğer servikal ve lomber patoloji tanıları konulabilir. Bu makalede iki brakial ve bir lomber pleksopati olmak üzere üç HZ pleksopati olgusu sunuldu. Elektrofizyolojik çalışma (EDX) bulguları, ekstremite parezisi, ağrı ve kabuklanmış cilt lezyonları ile birlikte pozitif VZV antikorları HZ pleksopatiye işaret etti. EDX bulguları brakial ve lomber pleksusun yamalı tutulumu ile uyumluydu. Antiviral tedavi ve fizyoterapi tüm olgularda kas gücünü hafif pareziye geriletti. Akut fazda doğru ve erken tanı kas gücünün total geri dönüşü için gereklidir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Brakiyal pleksus nöropatileri; elektromiyografi; herpes zoster; asiklovir; sakral pleksopati T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J N Ne eu ur r 2 20 01 16 6; ;1 11 1( (2 2)

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