Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient

Lee, Mi Hyun; Song, Jang Ho; Lee, Doo Ik; Ahn, Hyun Soo; Park, Ji‐Woong; Deog, Young

doi:10.3344/kjp.2013.26.1.76

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Such complications may arise before skin lesions appear and are likely underdiagnosed because they are masked by overriding pain [ 455 , 456 ]; they may also occur some time after HZ onset [ 452 , 457 , 458 ]. Other presentations include gastrointestinal or bladder dysfunction [ 10 ], myelitis [ 450 , 459 – 461 ], and myositis [ 462 ]. VZV infection is implicated in the aetiology of Guillain-Barré syndrome [ 463 – 465 ].…”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

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Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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“…The HZ-induced motor paresis is rare but can occur in 0.5% to 5% of patients [4]. It usually appears 2-3 weeks after the onset of the maculopapular rash [23]. It was reported that HZ-induced motor paresis typically lasts at least several months, which is associated with high rates of PHN [10].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, its characteristic symptom is a painful erythematous maculopapular rash in the involved dermatome [1]. Involvement of motor neurons is rare but occurs, leading to segmental motor paresis [234]. Most patients with zoster motor weakness will recover within one year of the onset, but 20% of the patients permanently experience weakness [3].…”

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confidence: 99%

Psoas compartment block for treatment of motor weakness and pain following herpes zoster

Kim

Park

et al. 2016

Korean J Pain

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Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ.

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“…It is therefore important to rule out spinal cord compression caused by an epidural hematoma. [ 3 ] If decompression is performed within 24 h of the initial symptoms, nerve injury can be minimized. The volume of the hematoma may play an important role in neurologic recovery, but this can vary depending on the relative size of the individual's spinal canal.…”

mentioning

confidence: 99%

Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis

Kim

Han

Kim

et al. 2018

Chinese Medical Journal

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Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient

Cited by 5 publications

References 13 publications

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Psoas compartment block for treatment of motor weakness and pain following herpes zoster

Spontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis

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