Acute monoplegia secondary to herpes zoster infection: a case report

Year 2017, Volume: 3 Issue: 1, 90 - 93, 04.03.2017

Meliha Kasapoglu Aksoy , Lale Altan Sezin Solum

https://doi.org/10.18621/eurj.293256

Abstract

Brachial plexopathy with motor involvement secondary to herpes zoster infection is very rare. Also known as shingles, herpes zoster occurs as a result of reactivation of varicella zoster virus in the dorsal root ganglia. We present a 69-year-old male patient with right upper extremity monoplegia secondary to herpes zoster infection. Physical examination showed scars from rash on his right antecubital fossa. Electroneuromyography showed a low amplitude motor response of the right median nerve, while having no sensation response at digits 1 and 3. Right ulnar and radial nerve sensation responses were lower in amplitude compared to the left side. Herpes zoster should be considered in the differential diagnosis of acute monoparesis. It is very important in avoiding unnecessary tests and treatments. 

Keywords

Herpes zoster infection, acute monoplegia, brachial plexopathy

References

• [1] Rastegar S, Mahdavi SB, Mahmoudi F, Basiri K. Herpes zoster segmental paresis 158 in an immunocompromised breast cancer woman. Adv Biomed Res 2015;4:170.
• [2] Ruppert LM, Freeland ML, Stubblefield MD. Segmental zoster paresis of the left upper limb in a pediatric patient. Am J Phys Med Rehabil 2010;89:1024-9.
• [3] Fabian VA, Wood B, Crowley P, Kakulas BA. Herpes zoster brachial plexus neuritis. Clin Neuropathol 1997;16:61-4.
• [4] Bradley G. W, Daroff B, Fenichel M. G, Jankovic J. Vascular diseases of nervous system. Neurology in Clinical Practice. 4th edn. Vol 1. Elsevier, Butterworth 155 Heinemann, 2004; pp. 343-8.
• [5] Ohtake T, Komon T, Hirose K, Tanabe H. Monoparesis due to the brachial plexus 167 neuritis by herpes zoster virus-report of a case. Rinsho Shinkeigaku 1991;31:1245-7.
• [6] Yoleri O, Olmez N, Oztura I, Sengul I, Gunaydın R, Memis A. Segmental zoster paresis of the upper extremity: a case report. Arch Phys Med Rehabil 2005;86:1492-4.
• [7] Eyigor S, Durmaz B, Karapolat H. Monoparesis with complex regional pain syndrome-like symptoms’ due to brachial plexopathy caused by the varicella zoster virus: a case report. Arch Phys Med Rehabil 2006;87:1653-5.
• [8] Ayoub T, Raman V, Chowdhury M. Brachial neuritis caused by varicella-zoster diagnosed by changes in barchial plexus on MRI. J Neurol 2010;257:1-4.
• [9] Alshekhlee A, Tay E, Buczek M, Shakir ZA, Katirji B. Herpes zoster with motor involvement: discordance between the distributation of skin rash and localization of peripheral nervous system dysfunction. J Clin Neuromuscul Dis 2011;12:153-7.
• [10] Jones LK, Reda H, Watson JC. Clinical, electrophysiological, and imaging features of zoster-associated limb paresis. Muscle Nerve 2014;50:177-85.