MONOPARESIS INFERIOR POST HERPES ZOSTER

Abstract

Background: Herpes zoster (HZ) is caused by reactivation of Varicella Zoster Virus (VZV). Segmental zoster paresis (SZP) is a rare neurological complication of HZ. Case: A 58-year-old woman came to our clinic with a complaint of a post HZ lesion accompanied by weakness, burning sensation, and paresthesia of the left lower limb. These complaints were felt suddenly about 2 weeks after the vesicles appeared. The patient had a history of diabetes mellitus (DM) and hypertension. From physical examination, there was a lesions on the L2-L3 dermatome which had dried out with hyperpigmentation and crusted.  Motoric examination of the left lower limb showed weakness of the hip flexors (MRC grade 3/5). While the power of the other muscles in right lower limb and in all muscles groups was MRC 5/5. Tonus and trophic was normal. There was hyperaesthesia noted in the left thigh in the L2-L3 dermatome. Discussion: Neurological complications in HZ can occur in the central nervous system or peripheral nervous system. In this case the patient had SZP as a complication of HZ that involving the motor system. This complication was characterized by paresis of the left lower limb after developing HZ infection. The pathogenesis of SZP remains unclear. Having a history of DM increases the incidence of neurological complications in HZ. This is because the effectiveness of cellular immunity against VZV in DM patients decreases. Conclusion: Segmental zoster paresis (SZP) is a rare neurological complication of HZ. SZP involves the motor nervous system. There are several risk factors that increase the incidence of neurological complications in HZ infection. Key words: Herpes Zoster, Segmental Zoster Paresis