Herpes zoster in the T1 dermatome presenting with Horner’s syndrome, radicular weakness, and postherpetic neuralgia

Herpes zoster in the T1 dermatome presenting with Horner’s syndrome, radicular weakness, and postherpetic neuralgia

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Jatin M. A partial remission took place in 8 months. Beck works, I can assure you of that. Her past history was significant for left internal capsule cerebrovascular infarction one year previous with no residual deficit, type II diabetes mellitus, pacemaker, migraine with aura and Herpes zoster infection diagnosed two weeks previously. Physical examination revealed right sided ptosis and meiosis. Scope of application: herpes zoster, recurrent herpes simplex, oral herpes, genital herpes, and various kinds of viruses cause genital warts;Especially suitable for influenza a, b, c, d type hepatitis patient hand disinfection.

Herpes zoster in the T1 dermatome presenting with Horner’s syndrome, radicular weakness, and postherpetic neuralgia
The right hand and the fingers were swollen; skin was warm, taut and glossy. A vesicular eruption was noted in the right T1–T2 distribution (). Computed tomography revealed no acute intracranial or intrathoracic processes. Edrophonium administration did not alter the physical signs. Dans la discussion du cas celui-ci est considéré à la lumière des hypothèses de Livingston et de de Takats concernant les troubles vasomoteurs dans la dystrophie réflective. The right medial ante brachial cutaneous sensory response was absent. Needle examination demonstrated fibrillation potentials and mildly large motor unit potentials with reduced recruitment in C8 to T1 innervated muscles.

Pharmacologic testing for Horner’s syndrome was not performed. Follow-up at 10 weeks revealed neuropathic pain affecting dermatomes C8 to T3, without sensory loss. Since CRPS is possible in subjects with herpes zoster affecting the distal extremity and indicates increased risk for development of post-herpetic neuralgia (PHN) a correct diagnosis is mandatory to prevent such complication. There was no change in her meiosis or ptosis. Herpes zoster (HZ) infection has an annual incidence of 3.2–4.2 per 1000 population per year in the general population,2 and 5.42 per thousand person years in adults over 60 years of age.3 The most frequent neurological manifestation is sensory nerve involvement resulting in a vesicular eruption of the skin and mucous membranes in the relevant dermatome. We present an unusual presentation of this HZ with Horner’s syndrome and postherpetic neuralgia. The occurrence of Horner’s syndrome is presumably due to involvement of the sympathetic pupillodilator pathway.

Varicella zoster viral reactivation and inflammation at the C8-T1 region of the spinal cord may interrupt the exiting sympathetic fibers.

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