RESUMO
We report a preterm neonate born with respiratory distress. The neonate was found to have diaphragmatic palsy and brachial palsy. The neonate was born by caesarean section and there was no history of birth trauma. On examination, there was bilateral congenital talipes equinovarus and a scar was present on the forearm. The mother had a history of chickenpox during the 16 weeks of pregnancy for which no treatment was sought. On investigation, PCR for varicella was found to be positive in the neonate.
Assuntos
Neuropatias do Plexo Braquial/virologia , Varicela/congênito , Pé Torto Equinovaro/virologia , Doenças Fetais/virologia , Antebraço/anormalidades , Complicações Infecciosas na Gravidez/virologia , Paralisia Respiratória/virologia , Aciclovir/uso terapêutico , Antibacterianos/uso terapêutico , Neuropatias do Plexo Braquial/fisiopatologia , Neuropatias do Plexo Braquial/terapia , Moldes Cirúrgicos , Cesárea , Varicela/transmissão , Pé Torto Equinovaro/terapia , Feminino , Doenças Fetais/fisiopatologia , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , Mães , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Paralisia Respiratória/fisiopatologia , Paralisia Respiratória/terapia , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this study was to report the case of a male patient with Parkinson disease who developed brachial plexopathy (BP) due to varicella-zoster virus, which was successfully treated with human immunoglobulin. METHOD: We report the case of a 75-year-old male subject with a diagnosis of Parkinson disease who came to our hospital complaining of pain, skin lesions, and strength loss in his right arm during the past 2 months. Physical examination revealed vesicular rash compatible with varicella-zoster virus lesions. Nerve conduction studies and magnetic resonance imaging of the brachial plexus showed inflammatory changes at that level. A trial with oral valacyclovir followed by intravenous methylprednisolone bolus was administered without further response. However, human intravenous immunoglobulin resulted in complete recovery of the symptoms. CONCLUSIONS: Human immunoglobulin is effective in BP due to zoster infection and must be considered if standard treatment fails. To the best of our knowledge, this is the first report of BP associated to zoster infection successfully treated with intravenous immunoglobulin.
Assuntos
Neuropatias do Plexo Braquial/tratamento farmacológico , Neuropatias do Plexo Braquial/etiologia , Encefalite por Varicela Zoster/complicações , Imunoglobulinas Intravenosas/uso terapêutico , Idoso , Neuropatias do Plexo Braquial/diagnóstico por imagem , Neuropatias do Plexo Braquial/virologia , Encefalite por Varicela Zoster/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Condução Nervosa/efeitos dos fármacos , Doença de Parkinson/complicaçõesRESUMO
Herpes zoster, commonly known as shingles, is an infectious viral disease characterized by painful, unilateral skin blisters occurring in specific sensory dermatomes. Motor paresis is reported in 0.5% to 5% of patients. Although the mechanism of zoster paresis is still unclear, the virus can spread from the dorsal root ganglia to the anterior horn cell or anterior spinal nerve roots. It rarely involves the brachial plexus. We report a case of brachial plexitis following herpes zoster infection in which pathological lesions were diagnosed using brachial plexus magnetic resonance imaging and treated with ultrasound-guided perineural corticosteroid injection.
Assuntos
Neuropatias do Plexo Braquial/tratamento farmacológico , Neuropatias do Plexo Braquial/virologia , Glucocorticoides/uso terapêutico , Herpes Zoster/complicações , Triancinolona/uso terapêutico , Idoso de 80 Anos ou mais , Plexo Braquial/patologia , Neuropatias do Plexo Braquial/reabilitação , Humanos , Injeções , Imageamento por Ressonância Magnética , Masculino , Medição da Dor , Ultrassonografia de IntervençãoRESUMO
We describe the case of a 54-year-old woman with West Nile virus infection presenting with painful brachial plexitis and radiculitis that preceded the more typically associated symptoms of meningoencephalitis. Physicians should be aware that West Nile virus infection can present with painful brachial plexitis.
Assuntos
Neuropatias do Plexo Braquial/virologia , Encefalomielite/virologia , Vírus do Nilo Ocidental/isolamento & purificação , Neuropatias do Plexo Braquial/diagnóstico , Neuropatias do Plexo Braquial/tratamento farmacológico , Diagnóstico Diferencial , Encefalomielite/diagnóstico , Encefalomielite/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Herpes zoster or shingles is the reactivation of dormant varicella zoster virus (VZV) in the dorsal root ganglia. Segmental motor paresis is rare and only few cases of brachial plexitis have been reported in the literature. This case reports herpes zoster resulting in unilateral brachial plexitis with predominant radial nerve palsy. The patient was treated successfully with aciclovir, gabapentin and physiotherapy with good recovery. Radial neuritis secondary to active herpes zoster has been rarely reported in the past.
Assuntos
Neuropatias do Plexo Braquial/virologia , Herpes Zoster/complicações , Neuropatia Radial/virologia , Idoso de 80 Anos ou mais , Feminino , Herpes Zoster/diagnóstico , Herpes Zoster/terapia , HumanosRESUMO
Brachial plexus neuritis in the presence of herpes zoster infection is uncommon. Motor involvement is probably due to the spreading of inflammation from the dorsal root ganglia to the ventral roots and may be more extensive than the affected dermatomes. We present a case of herpes zoster brachial plexopathy with pure motor involvement both clinically and electrophysiologically.
Assuntos
Neuropatias do Plexo Braquial/virologia , Herpes Zoster/complicações , Herpesvirus Humano 3 , Doença dos Neurônios Motores/virologia , Raízes Nervosas Espinhais/virologia , Aciclovir/uso terapêutico , Idoso , Anticorpos Antivirais/análise , Anticorpos Antivirais/sangue , Antivirais/uso terapêutico , Braço/inervação , Braço/patologia , Braço/fisiopatologia , Axônios/patologia , Axônios/virologia , Neuropatias do Plexo Braquial/patologia , Neuropatias do Plexo Braquial/fisiopatologia , Eletrodiagnóstico , Eletromiografia , Exantema/patologia , Exantema/fisiopatologia , Exantema/virologia , Humanos , Masculino , Doença dos Neurônios Motores/patologia , Doença dos Neurônios Motores/fisiopatologia , Neurônios Motores/patologia , Neurônios Motores/virologia , Debilidade Muscular/patologia , Debilidade Muscular/fisiopatologia , Debilidade Muscular/virologia , Músculo Esquelético/inervação , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Atrofia Muscular/patologia , Atrofia Muscular/fisiopatologia , Atrofia Muscular/virologia , Condução Nervosa , Raízes Nervosas Espinhais/patologia , Raízes Nervosas Espinhais/fisiopatologia , Falha de Tratamento , Degeneração Walleriana/patologia , Degeneração Walleriana/fisiopatologia , Degeneração Walleriana/virologiaAssuntos
Neuropatias do Plexo Braquial/virologia , Doenças do Nervo Facial/virologia , Doenças do Sistema Nervoso Periférico/virologia , Febre do Nilo Ocidental/complicações , Braço/inervação , Braço/fisiopatologia , Plexo Braquial/patologia , Plexo Braquial/fisiopatologia , Plexo Braquial/virologia , Neuropatias do Plexo Braquial/patologia , Neuropatias do Plexo Braquial/fisiopatologia , Diagnóstico Diferencial , Progressão da Doença , Músculos Faciais/inervação , Músculos Faciais/fisiopatologia , Nervo Facial/patologia , Nervo Facial/fisiopatologia , Nervo Facial/virologia , Doenças do Nervo Facial/patologia , Doenças do Nervo Facial/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Hipotonia Muscular/patologia , Hipotonia Muscular/fisiopatologia , Hipotonia Muscular/virologia , Doenças do Sistema Nervoso Periférico/patologia , Doenças do Sistema Nervoso Periférico/fisiopatologiaRESUMO
Viral invasion of the motoneurons and the subsequent inflammation in the anterior horn cells by the varicella zoster virus results in a weakness in the area of the cutaneous eruption. The exact mechanism of zoster paresis is uncertain. The occurrence of symptoms resembling complex regional pain syndrome (CRPS) is common in subjects where the herpes zoster (HZ) outbreak affects an extremity, particularly if it is the distal extremity that is involved. We report the case of a 54-year-old man with monoparesis, hyperalgesia, allodynia, edema, and both color and skin-temperature changes in his left arm after a skin eruption. Electrophysiologic examination revealed the partial degeneration of the superior, middle, and inferior truncus in the brachial plexus, with evidence of HZ infection. Magnetic resonance imaging of the cervical spine and brachial plexus showed degenerative changes without any evidence of nerve root compression. Brachial plexopathy may be the direct cause of the reversible upper-limb paresis resulting from HZ with CRPS-like symptoms.
Assuntos
Neuropatias do Plexo Braquial/virologia , Síndromes da Dor Regional Complexa/virologia , Herpes Zoster/diagnóstico , Herpesvirus Humano 3 , Paresia/virologia , Aciclovir/uso terapêutico , Analgésicos Opioides/uso terapêutico , Antivirais/uso terapêutico , Neuropatias do Plexo Braquial/terapia , Encéfalo/patologia , Síndromes da Dor Regional Complexa/terapia , Terapia por Estimulação Elétrica , Eletromiografia , Herpes Zoster/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Paresia/terapia , Modalidades de FisioterapiaRESUMO
Although amyotrophic lateral sclerosis and progressive spinal muscular atrophy have been recognized to occur in association with human immunodeficiency virus infection, to our knowledge, brachial amyotrophic diplegia, a form of segmental motor neuron disease, has not been previously reported. Brachial amyotrophic diplegia results in severe lower motor neuron weakness and atrophy of the upper extremities in the absence of bulbar or lower extremity involvement, pyramidal features, bowel and bladder incontinence, and sensory loss. We describe a human immunodeficiency virus-seropositive man without severe immunosuppression or prior AIDS-defining illnesses who had brachial amyotrophic diplegia. This disorder may represent one end of a spectrum of motor neuron diseases occurring with this retrovirus infection.