Segmental zoster paresis
Journal Title: Journal of General-Procedural Dermatology & Venereology Indonesia - Year 2017, Vol 2, Issue 1
Abstract
Herpes zoster is often associated with neurological manifestation but less frequently associated with motoric nerve involvement. The most common motoric involvement is paresis, seen only in 1-5% of all zoster cases. This case report a 39-year-old male, with recurrent abdominal liposarcoma under chemotherapy, presented with symptoms of fever, and painful and weak right leg for 2 weeks. Vesicles eruption was seen on his right leg nine days after these symptoms occurred. Physical examination revealed groups of haemorrhagic vesicles with erythematous base on the right lower leg. Lumbosacral spine x-ray showed spondylosis with radiculopathy. Electromyography (EMG) examination revealed lower motor neuron total denervation corresponding to right L5 radix. The patient was diagnosed as herpes zoster on right L5-S1 segment, herpetic neuralgia, and segmental zoster paresis with recurrent liposarcoma under chemotherapy. He was treated with oral acyclovir 800 mg five times a day and gabapentin 300 mg twice a day. Physical therapy and rehabilitation were started concurrently. Paresis is a rare complication of herpes zoster. Radicular pain and weakness preceded the skin lesion potentially lead to misdiagnoses. The most frequent diagnosis for patient suffering pain and weakness in the extremities is spinal disorder, such as stenosis and disc herniation. EMG can be helpful to recognise motoric involvement of herpes zoster, and preclude other diagnoses.
Authors and Affiliations
Nahla Shihab, Erdina Hardiono D Pusponegoro, Ahmad Yanuar
Keywords
Related Articles
- EP ID EP282021
- DOI 10.19100/jdvi.v2i1.36
- Views 124
- Downloads 0
Subcutaneous mycosis at the Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013
Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usua...
Failure to use routine prevention of disability (POD) assessment resulting In permanent disability
Disability is one of problems in leprosy or Morbus Hansen (MH), which can cause the patient loose his autonomy and may affect his social relationship with family and community. Disability occurs due to neurological infla...
Pulsed-dye laser efficacy in the treatment of psoriasis in adult patients: An evidence-based case report
Psoriasis is a chronic inflammatory skin disease known to be highly responsive to phototherapy. Narrow-band UVB (NBUVB) phototherapy has been one of the standard treatments for its moderate to severe form. However, its l...
Pattern of pigmentation disorder in Cosmetic Dermatology Clinic H. Adam Malik General Hospital, Medan, 2012 - 2015
Background: Abnormalities of pigmentation is a cosmetic problem which affects the overall appearance of an individual. Pigmentation disorder are caused by the increase (hypermelanosis) or the decrease (hypomelanosis) amo...
The comparison of skin irritation level between topical cajeput oil and telon oil: A pilot study
Background: Cajuputi/Cajeput/Melalueca leucadendron oil is a type of essential oil, widely known and used by Indonesian for infants, children, and elderly. It is also included in telon oil compositions (±42%). Excessive...