Paralysis in herpes zoster

Abstract

Herpes zoster is a relatively common disease which affects predominantly the middle-aged and elderly. The segmentally distributed cutaneous eruption, sensory changes, and pain make up the well known zoster syndrome. Motor loss is another aspect of this syndrome which is less well known but occurs in a significant number of cases, and is probably far more frequent than is recognised because the weakness is readily obscured by pain. Four cases of herpes zoster with motor involvement are described. Two cases had zoster paresis affecting the arm and hand, and one of these had, in limb, and one case had urinary retention owing to an atonic bladder. These cases serve to illustrate many of the clinical features of the zoster syndrome with motor involvement. The significant functional implications of unrecognised motor deficit, particularly in the elderly, are a prominent feature and highlight the importance of early accurate diagnosis and management. The pathogenesis and clinical features of this syndrome are discussed in the literature review.