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Zoster‐associated mononeuropathies (ZAMs): A retrospective series
Author(s) -
Reda Haatem,
Watson James C.,
Jones Lyell K.
Publication year - 2012
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23342
Subject(s) - paresis , mononeuropathy , medicine , weakness , complication , muscle weakness , magnetic resonance imaging , pathophysiology , neuralgia , external ophthalmoplegia , surgery , anesthesia , radiology , peripheral neuropathy , neuropathic pain , biochemistry , chemistry , endocrinology , gene , mitochondrial dna , diabetes mellitus
Zoster‐associated limb paresis is an uncommon complication of herpes zoster (HZ) and one whose precise pathophysiologic mechanism is poorly understood. Occasionally, the paresis results from a zoster‐associated mononeuropathy (ZAM). Methods: Mayo Clinic records between 1996 and 2010 were reviewed for patients with ZAM whose clinical, electrophysiologic, and radiographic features were then abstracted. Results: Ulnar (2), median (3), femoral (1), and sciatic (2) mononeuropathies were identified. Most patients had moderate to severe weakness in affected muscles, and most had post‐herpetic neuralgia (88% at 1 month and 71% at 4 months). The minimum duration of weakness was prolonged (mean, 281.9 days; range, 45–1242 days). Nerve magnetic resonance imaging (MRI) was abnormal, demonstrating nerve enlargement (4/4 cases), T2 signal hypertintensity (2/4 cases), or enhancement (1/4 cases). Conclusions: While ZAM is an uncommon occurrence following cutaneous HZ, it is associated with significant weakness, high rates of post‐herpetic neuralgia, and prolonged morbidity. Muscle Nerve, 2012