Department of Rehabilitation Medicine, Ichikawa City Rehabilitation Hospital, Ichikawa City, Japan.
Arch Phys Med Rehabil. 2010 Feb;91(2):321-5. doi: 10.1016/j.apmr.2009.10.011.
Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.
带状疱疹（HZ）引起的腹壁假性疝已被频繁报道，但尚未有报道描述 HZ 引起的躯干肌肉瘫痪导致功能问题。我们描述了一位 73 岁男性，因 HZ 引起的 T12 和 L1 节段性瘫痪，表现为腹壁假性疝、脊柱侧凸和站立及行走障碍，经系统康复治疗后反应良好。他在疱疹后第 6 周首次注意到右侧腹部膨出，第 12 周逐渐出现右侧凸胸腰椎侧凸、疼痛以及站立和行走障碍。针极肌电图显示右侧 T12 肌节肌肉有异常的静息自发性活动，运动单位募集明显减少。我们安排了一个门诊康复计划，包括使用软胸腰骶支具缓解疼痛和稳定躯干、瘫痪腹部肌肉的肌肉再教育、废用躯干和肢体肌肉的强化以及步态锻炼。根据肌电图结果，我们指导他采用一种有效的肌肉再教育方法。经过 4 个月的康复，他有了显著的改善并能户外行走。我们建议肌电图是评估 HZ 躯干瘫痪患者临床状况并制定有效康复计划的有用工具。
