ABSTRACT
Segmental zoster paresis is characterized by skin rash, sensory change and motor weakness in the myotome that corresponds to the dermatome of the rash. Herpes zoster induced pure motor paresis is a rare complication of herpes zoster without sensory involvement in brachial plexopathy. We present a case of segmental paresis, which involved motor nerve without sensory nerve involvement electrophysiologically.
Subject(s)
Brachial Plexus Neuropathies , Exanthema , Herpes Zoster , ParesisABSTRACT
Herpes zoster is a disease caused by the varicella zoster virus which affects the sensory nerves or peripheral branches of the cranial nerves. Segmental motor paresis, one of the complications of herpes zoster, is a rare complication which can occur two to three weeks after the skin rash develops and involves the corresponding muscle segments to the skin lesions caused by herpes zoster. We treated a patient with segmental zoster paresis who had a disorder similar to herpes zoster.
Subject(s)
Humans , Cranial Nerves , Exanthema , Herpes Zoster , Herpesvirus 3, Human , Paresis , Shoulder Impingement Syndrome , Shoulder , SkinABSTRACT
Segmental zoster paresis is a focal, asymmetric limb weakness caused by a herpes zoster infection. It is a rare complication of herpes zoster and the exact pathogenesis is uncertain. However, the most likely cause is the direct spread of the virus from the sensory ganglia to the anterior horn cells or anterior spinal nerve roots. We experienced two patients with segmental zoster paresis who showed both anterior and posterior root involvement on a gadolinium-enhanced MRI, supporting this hypothesis.
Subject(s)
Humans , Anterior Horn Cells , Extremities , Ganglia, Sensory , Herpes Zoster , Magnetic Resonance Imaging , Neuroimaging , Paresis , Spinal Nerve Roots , Spinal NervesABSTRACT
Segmental zoster paresis is characterized by focal, asymmetric motor weakness in the myotome corresponding to the dermatome of the rash. A 73-year-old man, who presented with severe right shoulder pain and shoulder girdle muscle weakness, was diagnosed with segmental zoster paresis involvement of the C5 C6 motor roots as a complication of herpes zoster. Girdle muscles (supraspinatus, deltoid and infraspinatus) atrophy had developed in his right shoulder. An MRI showed rotator cuff tearing in his right shoulder; therefore, an arthroscopic rotator cuff repair was performed. Herein, this case is presented to emphasize the importance of considering post-herpetic segmental motor paresis in the differential diagnosis of acute painful motor weakness of the upper extremities.