Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9434
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.
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.