Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Tsai, Jean; Bert, Robert J.; Gilden, Don

doi:10.1016/j.jns.2013.04.009

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Haanpää et al described focal nonenhancing brainstem hyperintense lesions in T2-weighted images in patients with trigeminal zoster without extraocular muscle involvement [ 4 ]. Our MRI findings demonstrated an even longer spreading of the abnormal hyperintensity signal on T2W compared to a case report by Tsai et al which described a long enhancing lesion from upper cervical cord extending to the lower thoracic spinal cord [ 6 ].…”

supporting

confidence: 48%

Severe Headache with Eye Involvement from Herpes Zoster Ophthalmicus, Trigeminal Tract, and Brainstem Nuclei

Siritho

Pumpradit

Suriyajakryuththana

et al. 2015

Case Reports in Radiology

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A 43-year-old female presented with severe sharp stabbing right-sided periorbital and retroorbital area headache, dull-aching unilateral jaw pain, eyelid swelling, ptosis, and tearing of the right eye but no rash. The pain episodes lasted five minutes to one hour and occurred 10–15 times per day with unremitting milder pain between the attacks. She later developed an erythematous maculopapular rash over the right forehead and therefore was treated with antivirals. MRI performed one month after the onset revealed small hypersignal-T2 in the right dorsolateral mid-pons and from the right dorsolateral aspect of the pontomedullary region to the right dorsolateral aspect of the upper cervical cord, along the course of the principal sensory nucleus and spinal nucleus of the right trigeminal nerve. No definite contrast enhancement of the right brain stem/upper cervical cord was seen. Orbital imaging showed no abnormality of bilateral optic nerves/chiasm, extraocular muscles, and globes. Slight enhancement of the right V1, V2, and the cisterna right trigeminal nerve was detected. Our findings support the hypothesis of direct involvement by virus theory, reflecting rostral viral transmission along the gasserian ganglion to the trigeminal nuclei at brainstem and caudal spreading along the descending tract of CN V.

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supporting

confidence: 48%

Severe Headache with Eye Involvement from Herpes Zoster Ophthalmicus, Trigeminal Tract, and Brainstem Nuclei

Siritho

Pumpradit

Suriyajakryuththana

et al. 2015

Case Reports in Radiology

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“…Whereas several cases report no pathologic findings in a MRI, 10-13 there is proof that a MRI can show nerve enlargement or enhancement. 13-15 One study showed the variation of imaging abnormalities based on the electrodiagnostic localization of the lesions. 16 In patients with preganglionic electrodiagnostic lesions the MRI showed no abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

2015

Orthop Rev

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We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

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Neuromuscular complications in cancer

Grisold

Löscher

2016

Journal of the Neurological Sciences

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Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Cited by 4 publications

References 7 publications

Severe Headache with Eye Involvement from Herpes Zoster Ophthalmicus, Trigeminal Tract, and Brainstem Nuclei

Severe Headache with Eye Involvement from Herpes Zoster Ophthalmicus, Trigeminal Tract, and Brainstem Nuclei

Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

Neuromuscular complications in cancer

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