Segmental zoster paresis of limbs: report of three cases and review of literature.
OBJECTIVE
Segmental zoster paresis is a relatively rare complication characterized by focal motor weakness, which may occur in limbs affected by herpes zoster. We demonstrate the clinical characteristics of segmental zoster paresis by reviewing the cases of 138 patients, including 3 of our patients.
We report 3 patients with zoster paresis of the limbs. Patients 1 and 3 showed motor weakness in the left shoulder and arm after developing a herpetic rash in the left C5-C6 dermatomes. Patient 2 showed weakness in the right thigh and groin after a right L2-L3 herpetic eruption. The electromyograms of all 3 patients showed abnormal spontaneous activity in the affected muscles. Intravenous acyclovir and corticosteroid pulse therapy were added to oral antiviral drugs for patients 1 and 2. All 3 patients recovered favorably. Our review of the literature revealed that antiviral treatment may prevent the occurrence of zoster paresis; however, there is insufficient evidence to show what treatment hastens recovery from zoster paresis.


CONCLUSIONS
Segmental zoster paresis is still underrecognized by neurologists. Awareness of this disorder is important because it may eliminate unnecessary invasive investigations and lead to appropriate treatment. Further studies on the treatment are necessary.
Kawajiri
Sumihiro
S
Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
Tani
Momo
M
Noda
Kazuyuki
K
Fujishima
Kenji
K
Hattori
Nobutaka
N
Okuma
Yasuyuki
Y
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D048909:Diabetes Complications; D004576:Electromyography; D005076:Exanthema / Q000209:etiology / Q000473:pathology; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D009431:Neural Conduction; D010243:Paralysis / Q000209:etiology* / Q000503:physiopathology*; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D034941:Upper Extremity
D000998:Antiviral Agents; D000212:Acyclovir