Zoster‐associated mononeuropathies (ZAMs): A retrospective series

Reda, Haatem; Watson, James C.; Jones, Lyell K.

doi:10.1002/mus.23342

Cited by 21 publications

(31 citation statements)

References 17 publications

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“…Normally, MRI scanning is not performed in patients with uncomplicated zoster. A PubMed search of patients with zoster paresis (lower motor neuron weakness corresponding to the dermatome where rash was present) revealed that MRI scans are normal [1-4] or that spinal cord lesions are present 1-2 levels adjacent to the area of segmental weakness [5-7]. Thus, to our knowledge, this is the first report of widespread subclinical imaging abnormalities far beyond the site of zoster and focal zoster paresis.…”

Section: Discussionmentioning

confidence: 99%

Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Tsai

Bert

Gilden

2013

Journal of the Neurological Sciences

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We describe a patient with zoster paresis and an MRI that revealed extensive spinal cord lesions from the upper cervical to the lower thoracic spinal cord. Importantly, the patient reported considerable spontaneous improvement in strength 2-3 weeks after zoster. This report reveals a previously undescribed remarkable preponderance of MRI lesions far beyond the site of zoster rash and focal lower motor neuron weakness.

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Section: Discussionmentioning

confidence: 99%

Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Tsai

Bert

Gilden

2013

Journal of the Neurological Sciences

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“…Electroneuromyography (ENMG) can help with the differential diagnosis of entrapment syndrome or radiculopathies, and may reveal variable electrophysiological findings in zoster-associated mono neuropathies (12,19,20).…”

Section: Discussionmentioning

confidence: 99%

“…There are reports of upper-limb herpes zoster patients presenting with concomitant paresis or paralysis (12,14). Notwithstanding motor involvement in herpes zoster can be diagnosed by ENMG, subclinical motor involvement is most likely underrecognized and underdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…There are few reports of ulnar nerve zoster reactivation in the literature (9)(10)(11), and most patients present with segmental zoster paresis of the upper extremity (12)(13)(14)(15). In a study on herpes zoster infection involving the hand and upper extremity, Kim et al found that three out of the five enrolled patients had ulnar nerve involvement, another one had radial nerve involvement, and in one case the medial antebrachial cutaneous nerve was involved.…”

Section: Introductionmentioning

confidence: 99%

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Herpes Zoster Reactivation Isolated to the Ulnar and Posterior Antebrachial Cutaneous Nerves – Case Report and Literature Review

2018

RoJCED

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Varicella-zoster virus (VZV) is a neurotropic virus which causes two distinct syndromes: primary infection presenting as varicella, mainly occurring in children without previous exposure to VZV, and reactivation of the latent VZV in the dorsal root ganglia, causing herpes zoster in adults. Herpes zoster clinically presents as a unilateral, painful, vesicular eruption, usually distribu ted to one or two adjacent thoracic dermatomes. As it is rarely seen confined to the upper limbs, few reports of herpes zoster involving the ulnar nerve exist in the literature, the majority describing patients who present with segmental zoster paresis of the upper extremity. This paper reports the case of a 73-year-old woman with ulnar and posterior antebrachial cuta neous nerve zoster reactivation and no history of immunosuppressive disorders. Therefore, rare occurrences of herpes zoster, such as the involvement of cervical dermatomes, should also be considered when faced with the differential diagnosis of symptomatic skin rashes of the upper limb, especially in elderly or immunosuppressed patients. Cite this article:Mihai Lupu, Maria Iris Popa, Carmen Draghici, Iulia Solomon, Vlad Mihai Voiculescu. Herpes zoster reactivation isolated to the ulnar and posterior antebrachial cutaneous nerves -case report and literature review. RoJCED 2018;5(2):52-xx.

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“…This investigation can be helpful to diagnose a patient with postherpetic neuralgia presenting after a variable asymptomatic period 21. MRI studies can also demonstrate abnormalities on affected nerves 20. Zoster-associated mononeuropathies may cause variable electrophysiological findings on ENMG investigation 20–22.…”

Section: Discussionmentioning

confidence: 99%

Cervical dermatomal zona misdiagnosed as ulnar nerve entrapment

et al. 2015

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SUMMARYHerpes zoster is a secondary reactivation of primary contagious varicella-zoster virus in the dorsal root ganglia. While thoracic zona is common, cervical dermatomal zona is a rare segmental complication of herpes zoster and can be easily misdiagnosed as other diseases. This article describes a patient with initial neuralgia without dermatomal lesions that was treated as ulnar nerve entrapment syndrome until manifestation of herpetiform cutaneous lesions appeared. It is important that clinicians should be aware of the possibility of zoster infection when evaluating the onset of neuralgia in a dermatomal distribution in the upper limb, especially without rash. BACKGROUND

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Zoster‐associated mononeuropathies (ZAMs): A retrospective series

Abstract: While ZAM is an uncommon occurrence following cutaneous HZ, it is associated with significant weakness, high rates of post-herpetic neuralgia, and prolonged morbidity.

Cited by 21 publications

References 17 publications

Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Zoster paresis: Asymptomatic MRI lesions far beyond the site of rash and focal weakness

Herpes Zoster Reactivation Isolated to the Ulnar and Posterior Antebrachial Cutaneous Nerves – Case Report and Literature Review

Cervical dermatomal zona misdiagnosed as ulnar nerve entrapment

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