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Muscle Nerve. 2012 May;45(5):734-9. doi: 10.1002/mus.23342.

Zoster-associated mononeuropathies (ZAMs): a retrospective series.

Author information

1
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, USA.

Abstract

INTRODUCTION:

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.

PMID:
22499102
DOI:
10.1002/mus.23342
[Indexed for MEDLINE]
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