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Clinical, electrophysiologic, and imaging features of zoster‐associated limb paresis
Author(s) -
Jones Lyell K.,
Haatem Reda,
Watson James C.
Publication year - 2014
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.24141
Subject(s) - medicine , paresis , mononeuropathy , weakness , postherpetic neuralgia , brachial plexopathy , muscle weakness , brachial plexus , electromyography , shingles , complication , peripheral neuropathy , surgery , amyotrophy , anesthesia , atrophy , physical medicine and rehabilitation , neuropathic pain , diabetes mellitus , endocrinology , virus , virology
: Paresis is a long‐recognized complication of herpes zoster, but there has been comparatively little study of zoster‐associated limb paresis (ZALP). Methods : In this study we reviewed 49 Mayo Clinic patients with ZALP. Results : The mean age of onset was 71 years, 67% were men, and the lower limb was affected in 55%. The mean weakness score was 2.0 (0 = normal strength, 4 = plegia). Most patients developed postherpetic neuralgia (PHN, 92% at 1 month and 65% at 3 months), and the average minimum duration of weakness was 193 days. ZALP was caused by radiculopathy (37%), plexopathy (41%), mononeuropathy (14%), and radiculoplexus neuropathy (8%). MRI demonstrated nerve enlargement, T2 signal prolongation, or enhancement in a majority (64%) of affected plexi and peripheral nerves. Conclusions : ZALP is associated with considerable weakness. It typically lasts at least several months, localizes to plexus or peripheral nerve in 63%, and is associated with high rates of PHN. Muscle Nerve 50:177–185, 2014