The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Zoster Paresis Misconceived as a Radiculopathy due to Herniated Intervertebral Disc

추간판 탈출증에 의한 신경근병증으로 오인된 대상포진성 부전마비

  • Kim, Hyun Jee (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine) ;
  • Yeo, Jin Seok (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine) ;
  • Jeon, Young Hun (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Jy Young (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine) ;
  • Ha, Mi Jin (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine) ;
  • Hong, Jung Gil (Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine)
  • 김현지 (경북대학교 의과대학 마취통증의학교실) ;
  • 여진석 (경북대학교 의과대학 마취통증의학교실) ;
  • 전영훈 (경북대학교 의과대학 마취통증의학교실) ;
  • 최지영 (경북대학교 의과대학 마취통증의학교실) ;
  • 하미진 (경북대학교 의과대학 마취통증의학교실) ;
  • 홍정길 (경북대학교 의과대학 마취통증의학교실)
  • Received : 2009.06.25
  • Accepted : 2009.07.15
  • Published : 2009.08.01
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Abstract

Herpes zoster is a viral disease of the posterior root ganglion and sensory nerve fiber, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, involvement of the motor neurons can be seen as well. If classic cutaneous lesions are present, herpes zoster-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be more difficult and suspicious, especially if weakness occurs as a symptom before cutaneous lesions appear, or abnormal findings on the MRI are consistent with the signs. There have been few reports of sciatica with motor loss preceding skin lesions. Here, we report a patient with herpes zoster-related motor paresis preceding skin lesions. In the preliminary diagnosis, the herpes zoster-related motor paresis was confused for some structural disorder.

Keywords

References

  1. Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ: Neurologic complications of the reactivation of varicella-zoster virus, N Engl J Med 2000; 342: 635-45 https://doi.org/10.1056/NEJM200003023420906
  2. Broadbent WH: Case of herpetic eruption in the course of branches of the brachial plexus, followed by partial paralysis in corresponding motor nerves, Br Med J 1866; 2: 460
  3. Kang WS, Yoon DM, Ahn EK, Lee SL: A spinal cord tumor found in the patient with herpes zoster radiculopathy, Korean J Anesthesiol 1996; 30: 224-7 https://doi.org/10.4097/kjae.1996.30.2.224
  4. Shapiro M: Herpes zoster related lumbar radiculopathy. Orthopedics 1996; 19: 976-7
  5. Schmader K: Herpes zoster in older adults. Clin Infect Dis 2001; 32: 1481-6 https://doi.org/10.1086/320169
  6. Sampathkumar P, Drage LA, Martin DP: Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc 2009; 84: 274-80 https://doi.org/10.4065/84.3.274
  7. Merchut MP, Gruener G: Segmental zoster paresis of limbs, Electromyogr Clin Neurophysiol 1996; 36: 369-75
  8. Helfgott SM, Picard DA, Cook JS: Herpes zoster radiculopathy, Spine 1993; 18: 2523-4 https://doi.org/10.1097/00007632-199312000-00024
  9. Tilki HE, Mutluer N, Selçcuki D, Staalberg E: Zoster paresis. Electromyogr Clin Neurophysiol 2003; 43: 231-4
  10. Kawajiri S, Tani M, Noda K, Fujishima K, Hattori N, Okuma Y: Segmental zoster paresis of limbs: report of three cases and review of literature. Neurologist 2007; 13: 313-7 https://doi.org/10.1097/NRL.0b013e31811e9d6d
  11. Yoleri O, Olmez N, Oztura I, Sengüul I, Güunaydin R, Memiş. A: Segmental zoster paresis of the upper extremity: a case report. Arch Phys Med Rehabil 2005; 86: 1492-4 https://doi.org/10.1016/j.apmr.2004.09.032
  12. Yaszay B, Jablecki CK, Safran MR: Zoster paresis of the shoulder. Case report and review of the literature. Clin Orthop Relat Res 2000; 377: 112-8 https://doi.org/10.1097/00003086-200008000-00016
  13. Stafford MA, Peng P, Hill DA: Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 2007; 99: 461-73 https://doi.org/10.1093/bja/aem238
  14. Postacchini F: Results of surgery compared with conservative management for lumbar disc herniations. Spine 1996; 21: 1383-7 https://doi.org/10.1097/00007632-199606010-00023
  15. Buttermann GR: Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 2004; 86-A: 670-9 https://doi.org/10.2106/00004623-200404000-00002
  16. Wendling D, Langlois S, Lohse A, Toussirot E, Michel F: Herpes zoster sciatica with paresis preceding the skin lesions. Three case-reports. Joint Bone Spine 2004; 71: 588-91 https://doi.org/10.1016/j.jbspin.2003.12.002
  17. Yeo JS, Sim WS, Kim YC: Herpes sine zoster: is the cause for the segmental intercostal neuralgia of unknown cause? Korean J Pain 2005; 18: 226-8 https://doi.org/10.3344/kjp.2005.18.2.226
  18. Sim WS, Choi JH, Han KR, Kim YC: Treatment of herpes zoster and postherpetic neuralgia. Korean J Pain 2008; 21: 93-105 https://doi.org/10.3344/kjp.2008.21.2.93

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