A Case of Herpes Zoster Presented with Lower Limb Paresis

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.

[1]  D. König,et al.  Lower Back Pain with Sciatic Disorder Following L5 Dermatome Caused by Herpes Zoster Infection , 2015, Orthopedic reviews.

[2]  T. Kon,et al.  Herpes zoster sciatica mimicking lumbar canal stenosis: a case report , 2015, BMC Research Notes.

[3]  Lyell K. Jones,et al.  Clinical, electrophysiologic, and imaging features of zoster‐associated limb paresis , 2014, Muscle & nerve.

[4]  D. Gilden,et al.  Neurological complications of varicella zoster virus reactivation. , 2014, Current opinion in neurology.

[5]  R. Hevner,et al.  Varicella-zoster virus trigeminal ganglioneuritis without rash , 2014, Neurology.

[6]  M. Bader,et al.  Herpes Zoster: Diagnostic, Therapeutic, and Preventive Approaches , 2013, Postgraduate medicine.

[7]  D. Gilden,et al.  The challenging patient with varicella-zoster virus disease. , 2013, Neurology. Clinical practice.

[8]  T. U. Kim,et al.  A Case of Herpes Zoster Peripheral Polyneuropathy Manifested by Foot Drop in Chronic Myeloid Leukemia , 2012, Annals of rehabilitation medicine.

[9]  J. Camilleri,et al.  Motor radiculopathy , 2012, BMJ Case Reports.

[10]  Lyell K. Jones,et al.  Zoster‐associated mononeuropathies (ZAMs): A retrospective series , 2012, Muscle & nerve.

[11]  L. Di Mascio,et al.  Herpes zoster virus: an unusual but potentially treatable cause of sciatica and foot drop. , 2011, Orthopedics.

[12]  Jeong-Yoon Choi,et al.  Brachial plexopathy following herpes zoster infection: Two cases with MRI findings , 2009, Journal of the Neurological Sciences.

[13]  A. Leo,et al.  Atypical herpes zoster infection preceded by sciatica and foot drop. , 2009, Archives of dermatology.

[14]  S. Naderi,et al.  Differential diagnosis of intraspinal and extraspinal non-discogenic sciatica , 2008, Journal of Clinical Neuroscience.

[15]  N. Hattori,et al.  Segmental Zoster Paresis of Limbs: Report of Three Cases and Review of Literature , 2007, The neurologist.

[16]  D. Wendling,et al.  Herpes zoster sciatica with paresis preceding the skin lesions. Three case-reports. , 2004, Joint, bone, spine : revue du rhumatisme.

[17]  M. Sawyer,et al.  Varicella-Zoster Virus Infections: Biology, Natural History, Treatment, and Prevention , 1988 .