Letter to the editorHerpes zoster motor neuropathy in an elderly man
Introduction
Herpes zoster (HZ) motor neuropathy, also known as segmental zoster paresis, is a rare neurologic complication of Varicella-Zoster virus reactivation and occurs in about 0.5–5% of patients with HZ [1], [2]. Because the incidence of HZ is 8–10 times higher in those aged ≥ 60 years than in younger people [3], the elderly population may be more susceptible to zoster–associated complications. In the current literature, rare case of HZ motor neuropathy with C5-T1 polyradiculopathy has been reported [4], [5].
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Case report
An 83-year-old man presented to our clinic with a history of right upper extremity pain and weakness for 6 months. Herpetic eruption over the C5-T1 dermatomes preceded his weakness by 1 week. The motor strength of his right upper limb was as follows: shoulder abductors 4-/5, elbow flexors 4-/5, wrist extensors 4-/5, finger flexors 3/5, and finger abductors 3/5. Laboratory work-up for thyroid function, syphilis, human immunodeficiency virus, hepatitis B, and hepatitis C showed no obvious
Discussion
HZ motor neuropathy most commonly involves the facial nerve, followed by the upper extremity and the lower extremity [6]. Among patients with upper extremity weakness, most cases have C5-C7 involvement, followed by C7-T1 and C5-T1 areas [5]. Focal motor weakness can appear in the same or beyond zoster eruption dermatomes and even extend ipsi- or contralaterally [7], [8]. The sites of motor damage may include the anterior horn, ventral roots, plexus, or peripheral nerves [7], [8]. The
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
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Cited by (1)
Looking back to move forward: A twenty-year audit of herpes zoster in Asia-Pacific
2017, BMC Infectious Diseases