The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지

Motor Paresis Caused by Herpes Zoster in Patients with Rotator Cuff Tear -A report cases-

회전근 개 파열환자에서 대상포진에 의한 운동신경 불완전마비 -증례보고-

  • Kim, Kee Hyun (Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Sohn, Yoon Suk (Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Yoon, Keon Jung (Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Song, Chul Hun (Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Oh, Sae Cheol (Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 김기현 (가톨릭대학교 의과대학 대전성모병원 마취통증의학과) ;
  • 손윤숙 (가톨릭대학교 의과대학 대전성모병원 마취통증의학과) ;
  • 윤건중 (가톨릭대학교 의과대학 대전성모병원 마취통증의학과) ;
  • 송철헌 (가톨릭대학교 의과대학 대전성모병원 마취통증의학과) ;
  • 오세철 (가톨릭대학교 의과대학 대전성모병원 마취통증의학과)
  • Received : 2006.09.08
  • Accepted : 2006.12.07
  • Published : 2006.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

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.

Keywords

References

  1. Head H, Campbell AW, Kennedy PG: The pathology ofherpes zoster and its bearing on sensory localization. Rev Med Virol 1997; 7: 131-43 https://doi.org/10.1002/(SICI)1099-1654(199709)7:3<131::AID-RMV198>3.0.CO;2-7
  2. Braverman DL, Ku A, Nagler W: Herpes zoster tadiculopathy. Arch Phy Med Rehabil 1997; 78: 880-2 https://doi.org/10.1016/S0003-9993(97)90204-5
  3. Gupta SK, Helal BH, Kiely P: The prognosis in zostet patalysis. J Bone Joint Surg Br 1969; 51: 593-603
  4. Thomas JE, Howard FM Jr: Segmental zoster paresis - a disease profile. Neurology 1972; 22: 459-66 https://doi.org/10.1212/WNL.22.5.459
  5. Straus SE, Reinhold W, Smith HA, Ruyerchan WT, Henderson DK, Blaese RM, et al: Endonnclease analysis of vital DNA from varicella and subsequent zoster infections in the same patient. N Engl J Med 1984; 311: 1362-4 https://doi.org/10.1056/NEJM198411223112107
  6. Metchut MP, Gruener G: Segmental zoster paresis of limbs. Electromyogr Clin Neurophysiol 1996; 36: 369-75
  7. Gottschau P, Trojaborg W: Abdominal muscle paralysis associated with herpes zoster. Acta Neural Scand 1991; 84: 344-7 https://doi.org/10.1111/j.1600-0404.1991.tb04966.x
  8. Stowasser M, Cameron J, Olivet WA: Diaphragmatic patalysis following cetvical herpes zoster. Med J Aust 1990; 153: 555-6
  9. Akiyama N: Herpes zoster infection complicated by motor paralysis. J Dermatol 2000; 27: 252-7 https://doi.org/10.1111/j.1346-8138.2000.tb02160.x
  10. Burkman KA, Gaines WR Jr, Kashani SR, Smith RD: Herpes zoster: a consideration in the differential diagnosis of radiculopathy. Arch Phys Med Rehabil 1988; 69: 132-4
  11. Mondelli M, Romano C, Della Porta P, Rossi A: Electrophysiological findings in peripheral fibers of subjects with and without post-herpetic neuralgia. Elecrroencephalogr Clin Neurophysiol 1996; 101: 185-91 https://doi.org/10.1016/0924-980X(96)95673-8
  12. Rosenfeld T, Price MA: Paralysis in herpes zoster. Aust NZ J Med 1985; 15: 712-6
  13. Cioni R, Giannini F, Passero S, Paradiso C, Rossi S, Firniani M, et al: An electromyographic evaluation of motor complications in thoracic herpes zoster. Elecrromyogr Clin Neurophysiol 1994; 34: 125-8
  14. Greenberg MK, McVey AL, Hayes T: Segmental motor involvement in herpes zoster. An EMG study. Neurology 1992; 42: 1122-3 https://doi.org/10.1212/WNL.42.5.1122
  15. Haanpaa M, Hakkinen V, Nurmikko T: Motor involvement in acute herpes zoster. Muscle Nerve 1997; 20: 1433-8 https://doi.org/10.1002/(SICI)1097-4598(199711)20:11<1433::AID-MUS11>3.0.CO;2-2
  16. Sachs GM: Segmental zoster paresis: an electrophysiological study. Muscle Nerve 1996; 19: 784-6 https://doi.org/10.1002/(SICI)1097-4598(199606)19:6<784::AID-MUS17>3.0.CO;2-L
  17. Esposito MB, Arrington JA, Murtaugh FR, Coleman JM, Sergay SM: MR of the spinal cord in patient with herpes zoster. Am J Neuroradiol 1993; 14: 203-4
  18. Rice JP: Segmental motor paralysis in herpes zoster. Clin Exp Neurol 1984; 20: 129-40