Atypical Herpes Zoster Infection Preceded by Sciatica and Foot Drop

Leo, Angela M.; Kasper, David A.; Saxena, Aradhna

doi:10.1001/archdermatol.2009.168

Cited by 10 publications

(19 citation statements)

References 3 publications

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“…There was also a time lag between the neuralgia and skin manifestations in the present case, which led to a delay in diagnosis. In fact, the onset of sciatica preceded the skin lesions by 1 month, which was a protracted time lag compared with previous reports [ 2 ]. Therefore, sciatica might be induced by a lumbar spine lesion during the initial period after onset, and might be superseded by a herpes zoster infection during the course of the disease.…”

Section: Discussionmentioning

confidence: 65%

“…There is a time lag between the two major symptoms of herpes zoster; neuralgia generally precedes the manifestation of skin lesions for several days to 1 week [ 2 ]. The time lag can make it difficult to distinguish sciatica of the lumbar spine origin from herpes zoster infection [ 2 ]. There was also a time lag between the neuralgia and skin manifestations in the present case, which led to a delay in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Years or decades after a VZV infection, however, the virus may cause viral infection of the skin along the corresponding dermatome of the affected nerve [ 1 ]. The characteristic symptoms of herpes zoster can make it difficult to distinguish from sciatica induced by spinal diseases, including lumbar disc herniation and spinal canal stenosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Herpes zoster sciatica mimicking lumbar canal stenosis: a case report

et al. 2015

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BackgroundSymptom of herpes zoster is sometimes difficult to distinguish from sciatica induced by spinal diseases, including lumbar disc herniation and spinal canal stenosis. Here we report a case of sciatica mimicking lumbar canal stenosis.Case presentationA 74-year-old Chinese male patient visited our hospital for left-sided sciatic pain upon standing or walking for 5 min of approximately 1 month’s duration. At the first visit to our hospital, there were no skin lesions. A magnetic resonance imaging showed spinal canal stenosis between the 4th and 5th lumbar spine. Thus, we diagnosed the patient with sciatica induced by spinal canal stenosis. We considered decompression surgery for the stenosis of 4th and 5th lumbar spine because conservative therapy failed to relieve the patient’s symptom. At that time, the patient complained of a skin rash involving his left foot for several days. A vesicular rash and erythema were observed on the dorsal and plantar surfaces of the great toe and lateral malleolus. The patient was diagnosed with herpes zoster in the left 5th lumbar spinal nerve area based on clinical findings, including the characteristics of the pain and vesicular rash and erythema in the 5th lumbar spinal dermatome. The patient was treated with famciclovir (1,500 mg/day) and non-steroidal anti-inflammatory drugs. After 1 week of medication, the skin rash resolved and pain relief was obtained.ConclusionIn conclusion, spinal surgeons should keep in mind herpes zoster infection as one of the possible differential diagnoses of sciatica, even if there is no typical skin rash.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1272-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Herpes zoster sciatica mimicking lumbar canal stenosis: a case report

et al. 2015

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“…The prognostic factor is still unclear yet, but the risk of the persisting symptom may get higher if treatment is delayed [ 17 ]. Also, it was postulated that poorer recovery is expected when motor neuropathy precedes the rash, as in our case, than when motor neuropathy follows the rash [ 12 ]. The patient in our case had only a partial recovery of paresis until three months after treatment, so longer-term follow up with continuous rehabilitation would be necessary.…”

Section: Discussionmentioning

confidence: 89%

“…The localization of motor abnormality can be also challenging because the involved myotomes do not always correspond to the dermatomes affected by a zoster skin rash [ 14 ]. The EMG-NCV tests have been generally used to evaluate the extent of herpes zoster-associated neuropathy [ 4 , 12 - 13 , 15 ]. However, the accuracy of those studies may vary depending on the physician’s skill and often difficult to test immediately.…”

Section: Discussionmentioning

confidence: 99%

A Case of Herpes Zoster Presented with Lower Limb Paresis

Choi

2018

Cureus

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Herpes zoster is a common viral disorder that typically shows characteristic painful skin lesion. Motor neuropathy rarely complicates herpes zoster infection, and it may be overlooked without suspicion. Here, we report a case of a herpes zoster patient who presented with sciatica and paresis, but without the typical skin lesion. The patient was initially misdiagnosed as having other disorders including trauma or spine lesion. Electrodiagnostic study and magnetic resonance imaging (MRI) helped to make an accurate diagnosis and localize the motor nerve involvement of herpes zoster.

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Herpes Zoster Virus (Shingles) Infection

Akhaddar

2023

Atlas of Sciatica

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Atypical Herpes Zoster Infection Preceded by Sciatica and Foot Drop

Cited by 10 publications

References 3 publications

Herpes zoster sciatica mimicking lumbar canal stenosis: a case report

Herpes zoster sciatica mimicking lumbar canal stenosis: a case report

A Case of Herpes Zoster Presented with Lower Limb Paresis

Herpes Zoster Virus (Shingles) Infection

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