Search
segmental zoster paresis
Epidemiology:
- 3-5% of patients with cutaneous Herpes zoster
Clinical manifestations:
- segmental weakness involving the arm or leg corresponding to distribution of nerve root(s) that give rise to the dermatomal distribution
- weakness starts within 2 weeks of cutaneous eruption
- involves proximal muscles more commonly
- limited to 2-3 myotomes
- pain may hinder examination for weakness
Special laboratory:
- nerve conduction studies show reduced amplitudes of action potentials in sensory & compound motor nerves
- needle electromyography 2-3 weeks after onset commonly shows abnormal spontaneous activity in weak muscles, if done later may reveal reinnervation with prolonged & polyphasic motor unit potentials
Management:
- intravenous acyclovir with or without glucocorticoids, benefit of antiviral &/or glucocorticoids not established
- prognosis is good
- generally patients recover most function
- 50% recover all function
General
Herpes zoster (shingles)
References
- Kawajiri S et al,
Segmental zoster paresis of limbs. Report of three cases &
reviez of the literature.
Neurologist 2007, 13:313
PMID: 17848871