Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2022; 10(26): 9434-9439
Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9434
Complete recovery from segmental zoster paresis confirmed by magnetic resonance imaging: A case report
Jihwan Park, Wooyong Lee, Yunhee Lim
Jihwan Park, Wooyong Lee, Yunhee Lim, Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, South Korea
Author contributions: Park J wrote the main manuscript draft and collected image data; Lee W was the patient's doctor and helped to collect the patient's information; Lim Y revised the manuscript; all authors approved the final manuscript for submission.
Informed consent statement: Informed written consent was obtained from the patient's family for this report publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist 2016, and the manuscript was prepared and revised according to the CARE Checklist.
Open-Access: This article is an open-access article selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yunhee Lim, MD, PhD, Associate Professor, Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, No. 1342 Dongil-ro, Nowon-gu, Seoul 01757, South Korea.
Received: April 19, 2022
Peer-review started: April 19, 2022
First decision: June 7, 2022
Revised: June 19, 2022
Accepted: August 6, 2022
Article in press: August 6, 2022
Published online: September 16, 2022

Segmental zoster paresis, depending on the affected area, can present with severe clinical manifestations and render patients unable to perform activities of daily living. Therefore, it is necessary to diagnose and treat such a condition rapidly. No studies have reported using magnetic resonance imaging (MRI) to identify clinical abnormalities associated with this condition or its complete recovery. This rare case report evaluated the changes in MRI findings before and after the patient's motor symptoms recovered.


A 79-year-old woman with a history of rheumatoid arthritis and psoriasis visited the hospital for skin rashes and pain in the C5-T2 segments. The diagnosis was herpes zoster infection, and treatment was initiated. However, motor weakness suddenly occurred 14 d after the initial symptom presentation. We confirmed abnormal findings in the nerves and muscles invaded by the shingles using electromyography and MRI. After 17 mo, the patient's symptoms had completely normalized, and MRI confirmed that there were no abnormalities.


MRI can be a useful diagnostic modality for segmental zoster paresis and patient evaluation during recovery from motor complications.

Keywords: Complication, Electromyography, Herpes zoster, Magnetic resonance imaging, Paresis, Case report

Core Tip: Segmental zoster paresis is a rare motor complication of herpes zoster infection. Generalized severe pain and a low incidence of motor complications make its diagnosis challenging for clinicians. It can present with various motor symptoms depending on the affected area. Although the prognosis of segmental zoster paresis is known to be fair, it is important to administer multiple treatments promptly, considering the relatively long period required for recovery from motor symptoms. Magnetic resonance imaging can be advantageous in the diagnosis of segmental zoster paresis and its evaluation after recovery.