Subject(s)
Brachial Plexus/diagnostic imaging , Herpesvirus 3, Human/isolation & purification , Median Nerve/diagnostic imaging , Peripheral Nervous System Diseases/diagnostic imaging , Radial Nerve/diagnostic imaging , Aged , Brachial Plexus/virology , Humans , Male , Median Nerve/virology , Peripheral Nervous System Diseases/virology , Radial Nerve/virology , Radiculopathy , Varicella Zoster Virus Infection/complications , Varicella Zoster Virus Infection/diagnostic imagingSubject(s)
Brachial Plexus Neuropathies/virology , Facial Nerve Diseases/virology , Peripheral Nervous System Diseases/virology , West Nile Fever/complications , Arm/innervation , Arm/physiopathology , Brachial Plexus/pathology , Brachial Plexus/physiopathology , Brachial Plexus/virology , Brachial Plexus Neuropathies/pathology , Brachial Plexus Neuropathies/physiopathology , Diagnosis, Differential , Disease Progression , Facial Muscles/innervation , Facial Muscles/physiopathology , Facial Nerve/pathology , Facial Nerve/physiopathology , Facial Nerve/virology , Facial Nerve Diseases/pathology , Facial Nerve Diseases/physiopathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Muscle Hypotonia/pathology , Muscle Hypotonia/physiopathology , Muscle Hypotonia/virology , Peripheral Nervous System Diseases/pathology , Peripheral Nervous System Diseases/physiopathologySubject(s)
Brachial Plexus Neuropathies/virology , Infectious Mononucleosis/complications , Muscular Atrophy/virology , Adolescent , Arm/innervation , Arm/physiopathology , Brachial Plexus/immunology , Brachial Plexus/physiopathology , Brachial Plexus/virology , Brachial Plexus Neuropathies/immunology , Brachial Plexus Neuropathies/physiopathology , Electromyography , Fever/virology , Humans , Male , Muscle Weakness/immunology , Muscle Weakness/physiopathology , Muscle Weakness/virology , Muscle, Skeletal/innervation , Muscle, Skeletal/physiopathology , Muscular Atrophy/immunology , Muscular Atrophy/physiopathology , Somatosensory Disorders/immunology , Somatosensory Disorders/physiopathology , Somatosensory Disorders/virology , Tonsillitis/virologyABSTRACT
This is the first report of brachial plexus inflammation associated with clinical herpes zoster paresis. A 78-year-old female with a 3-week history of herpes zoster of the C4, C5, and C6 dermatomes developed left upper arm monoplegia. She died from an acute myocardial infarction. Post-mortem provided a rare opportunity to study the neuropathology of herpes zoster motor involvement. Histology of the brachial plexus showed extensive lymphocytic infiltration, myelin breakdown, and preservation of axons without vasculitis. The cervical spinal cord showed perivascular lymphocytic cuffing and no anterior horn necrosis. We suggest, the brachial plexus inflammation was a distal extension of a dorsal ganglionitis. Brachial plexus neuritis may be a direct cause of reversible upper limb paresis in herpes zoster. We demonstrate the motor neuropathy is an inflammatory demyelinative process consistent with the recovery observed in a number of patients. We postulate post-herpetic neuralgia may be related to an ongoing inflammatory process.
