- 期刊
Herpes Zoster and resultant Segmental Zoster Paresis: A Case Report and Literature Review
帶狀皰疹誘發之肢體無力：病例報告及文獻回顧
摘要
Herpes zoster (HZV) is ascribed to the reactivation of the dormant varicella-zoster virus (VZV) in the dorsal root ganglia. The most commonly seen manifestation is a painful skin rash. However, several additional complications have been documented in the literature. A less-mentioned yet severe complication is segmental zoster paresis (SZP), which can cause limb paralysis. SZP's mechanism is still under debate, and a direct invasion of motor fibers due to anatomical adjacency has been proposed. Here we report a patient who had sudden onset of left upper limb paresis and gradually developed a skin rash afterward, which a dermatologist confirmed as HZV, and who received proper anti-viral management. However, the paresis persisted despite the skin rash subsiding. We concluded a diagnosis of SZP based on clinical manifestation, physical examination, musculoskeletal ultrasound examination, and electrodeagnostic studies.
並列摘要
帶狀皰疹是歸因於背根神經節中休眠的水痘－帶狀皰疹病毒再激活而造成。最常見的表現是疼痛的皮疹。然而，文獻中也記錄了一些額外的併發症，其中一個較少被提及但嚴重的併發症是節段性帶狀皰疹麻痺，會導致肢體癱瘓。節段性帶狀皰疹麻痺的確切機制目前仍無定論，有人提出是由於解剖構造的相鄰而直接侵入運動纖維導致我們提出一名患者，產生突發性的左上肢麻痺，而後再逐漸出現皮疹；經皮膚科醫生確診為帶狀皰疹感染，並接受了適當的抗病毒治療。然而，儘管皮疹已經消退，但麻痺的情形依舊存在。我們依據患者的臨床表現，透過理學檢查、肌肉骨骼超音波檢查、以及電學診斷，確立節段性帶狀皰疹麻痺的診斷。