Zoster-associated limb paralysis mimicking acute stroke: a case report

Dalugama, Chamara; Jayasinghe, Ruwanthi; Rathnayaka, Nimanthi; Medagama, Arjuna

doi:10.1186/s13256-021-02971-7

Cited by 2 publications

(2 citation statements)

References 22 publications

(22 reference statements)

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“…74 Herpetic plexitis or neuropathies may present with weakness and sensory loss or pain in the areas adjacent to the rash. 75 Focal neuropathy can occur from trauma, nerve compression,…”

Section: Approach To Focal Weakness: Radiculopathies Plexopathies And...mentioning

confidence: 99%

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Peripheral nervous system and neuromuscular disorders in the emergency department: A review

Sivadasan,

Cortel‐LeBlanc,

Cortel‐LeBlanc

et al. 2024

Academic Emergency Medicine

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IntroductionAcute presentations and emergencies in neuromuscular disorders (NMDs) often challenge clinical acumen. The objective of this review is to refine the reader's approach to history taking, clinical localization and early diagnosis, as well as emergency management of neuromuscular emergencies.MethodsAn extensive literature search was performed to identify relevant studies. We prioritized meta‐analysis, systematic reviews, and position statements where possible to inform any recommendations.SummaryThe spectrum of clinical presentations and etiologies ranges from neurotoxic envenomation or infection to autoimmune disease such as Guillain–Barré Syndrome (GBS) and myasthenia gravis (MG). Delayed diagnosis is not uncommon when presentations occur “de novo,” respiratory failure is dominant or isolated, or in the case of atypical scenarios such as GBS variants, severe autonomic dysfunction, or rhabdomyolysis. Diseases of the central nervous system, systemic and musculoskeletal disorders can mimic presentations in neuromuscular disorders.ConclusionsFortunately, early diagnosis and management can improve prognosis. This article provides a comprehensive review of acute presentations in neuromuscular disorders relevant for the emergency physician.

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“…74 Herpetic plexitis or neuropathies may present with weakness and sensory loss or pain in the areas adjacent to the rash. 75 Focal neuropathy can occur from trauma, nerve compression,…”

Section: Approach To Focal Weakness: Radiculopathies Plexopathies And...mentioning

confidence: 99%

“…Brachial plexitis has restricted forms involving the phrenic, axillary, anterior and posterior interosseus nerves 74 . Herpetic plexitis or neuropathies may present with weakness and sensory loss or pain in the areas adjacent to the rash 75 …”

Section: Other Presentations and Complications Of Neuromuscular Disor...mentioning

confidence: 99%

Peripheral nervous system and neuromuscular disorders in the emergency department: A review

Sivadasan,

Cortel‐LeBlanc,

Cortel‐LeBlanc

et al. 2024

Academic Emergency Medicine

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Zoster-associated Limb Paralysis: Clinical and Electrophysiological Data of 15 Cases with Segmental Zoster Paresis with the Literature Review

Aykac,

Arı,

Ozoglan

et al. 2024

Neurological Sciences and Neurophysiology

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Background: Herpes zoster (HZ) is a viral disease characterized by skin eruptions and pain in specific dermatomes. Focal motor weakness that appears in the segment of skin eruptions is a rare complication of this infection. Because of the difficulty in clinically diagnosing thoracic or upper cervical motor weakness and due to the pain that causes overlooking of weakness, the true incidence of this complication is not known. In this study, we want to review the clinical presentation of segmental zoster paresis and also discuss electrophysiological findings with the involvement of nerve, plexus parts, or spinal roots. Methods: Electromyography records were examined retrospectively from 2010 to 2023 for patients who had HZ-associated limb paresis. Clinical data were reviewed and abstracted, and patients whose clinical limb weakness and sensory deficits conformed to the distribution of peripheral nerve (s) or spinal root and whose electrodiagnostic evaluation corroborated the localization, were included in the series. Results: Fifteen patients were included in our study. Ten of them were men and five of them were women. Paresis and neuropathic pain are the main complaints. In all patients, the distribution of paresis was consistent with the area of skin eruptions. C8–T1 in the upper extremity and L5–S1 in the lower extremity are the most commonly involved segments. Electrophysiological findings showed radicular involvement in three cases, brachial plexus in six cases, ulnar nerve in one case, sciatic nerve in two cases, and fibular nerve in three cases. Axonopathy is the main detected pathology in all cases. Conclusion: Segmental zoster paresis is a rare complication of cutaneous zona zoster and it affects different nerve segments. Clinicians should be aware of clinical and electrophysiological findings of this disease for the appropriate management of the patients.

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Zoster-associated limb paralysis mimicking acute stroke: a case report

Cited by 2 publications

References 22 publications

Peripheral nervous system and neuromuscular disorders in the emergency department: A review

Peripheral nervous system and neuromuscular disorders in the emergency department: A review

Zoster-associated Limb Paralysis: Clinical and Electrophysiological Data of 15 Cases with Segmental Zoster Paresis with the Literature Review

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