Highlights
- •Although infrequent, herpes zoster may result in motor neuropathy.
- •Motor involvement in the abdominal wall may develop a pseudohernia.
- •We report a case of abdominal wall post-herpetic pseudohernia.
- •MRI demonstrated signs of acute denervation in the abdominal wall muscles.
- •Pseudohernia does not require surgical intervention and has favorable prognosis.
Abstract
Herpes zoster is caused by the reactivation of latent varicella-zoster virus from
dorsal root ganglia. Although infrequent, simultaneous damage to the anterior horn
cells or anterior nerve roots at the same level may result in motor neuropathy. When
motor involvement is localized in the abdominal wall, a pseudohernia may be the clinical
presentation. We report a case of abdominal wall post-herpetic pseudohernia, with
clinical, ultrasound and MRI correlation. MRI demonstrated increased T2/STIR signal
intensity in the abdominal wall muscles, suggesting acute denervation. To our knowledge,
this is the first case report of postherpetic pseudohernia with acute denervation
demonstrated on MRI.
Keywords
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References
- Neurologic complications of the reactivation of varicella-zoster virus.N Engl J Med. 2000; 342: 635-645
- Postherpetic abdominal-wall pseudohernia.Clin Exp Dermatol. 2008; 33: 677-678
- MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash.Skeletal Radiol. 2014; 43: 1481-1485
- Abdominal-wall postherpetic pseudohernia.Hernia. 2006; 10: 364-366
- Herpes zoster-induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report.Arch Phys Med Rehabil. 2010; 91: 321-325
- An electromyographic evaluation of motor complications in thoracic herpes zoster.Electromyogr Clin Neurophysiol. 1994; 34: 125-128
- Acquired neurogenic abdominal wall weakness simulating abdominal hernia.Isr Med Assoc J. 2002; 4: 262-264
- Herpes zoster and its neurological complications.Postgrad Med J. 1987; 63: 85-89
- Motor involvement in acute herpes zoster.Muscle Nerve. 1997; 20: 1433-1438
- Population-based study of herpes zoster and its sequelae.Medicine (Baltimore). 1982; 61: 310-316
- Segmental zoster paresis – a disease profile.Neurology. 1972; 22: 459-466
- The prognosis in zoster paralysis.J Bone Joint Surg Br. 1969; 51: 593-603
- Motor paralysis of abdominal muscles due to herpes zoster.Pain Clinic. 1987; 8: 637-642
- Segmental zoster abdominal paresis (zoster pseudohernia): a review of the literature.PM R. 2013; 5: 786-790
- Magnetic resonance imaging in a patient with segmental zoster paresis.Neurology. 1997; 49: 631-632
- Neurological picture. Findings of segmental zoster paresis on MRI.J Neurol Neurosurg Psychiatry. 2011; 82: 694
- MRI of segmental zoster paresis.Neurology. 2005; 64: 1138
- Abdominal pseudohernia caused by herpes zoster truncal D12 radiculoneuropathy.Arch Neurol. 2006; 63: 1327
- Segmental zoster paresis: an electrophysiological study.Muscle Nerve. 1996; 19: 784
- Herpes zoster of the head and limbs: electroneuromyographic and clinical findings in 158 consecutive cases.Arch Phys Med Rehabil. 2002; 83: 1215-1221
- MRI findings in inflammatory muscle diseases and their noninflammatory mimics.AJR Am J Roentgenol. 2009; 192: 1708-1716
- MRI appearance of muscle denervation.Skeletal Radiol. 2008 May; 37: 397-404
- Motor denervation of tumors of the head and neck: changes in MR appearance.Magn Reson Med Sci. 2002; 1: 157-164
Article info
Publication history
Published online: January 09, 2018
Accepted:
January 8,
2018
Received in revised form:
December 26,
2017
Received:
November 8,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
