Kesserwani Hassan
Neurology, Flowers Medical Group, Dothan, USA.
Cureus. 2020 Dec 19;12(12):e12171. doi: 10.7759/cureus.12171.
Post-herpetic lumbar plexopathy (post-herpetic segmental paresis), immune-mediated lumbar plexopathy and diabetic radiculoplexopathy (diabetic amyotrophy) have similar and seemingly parallel semiologies. The latter two conditions have an underlying microvasculitic pathological substrate that has shown potential (yet unproven) amelioration with immunodulatory therapy. These observations gave us the motivation to treat our patient with intravenous methylprednisolone for a profound proximal left leg weakness due to post-herpetic segmental paresis. In this case report, we outline in detail the clinical and electophysiolgical phenotype of this disease and we demonstrate the spectacular improvement of left leg power that had previously remained static for three months. In the discussion section, we review the vascular invasiveness of the varicella-zoster virus.
疱疹后腰椎丛病变（疱疹后节段性轻瘫）、免疫介导的腰椎丛病变和糖尿病性神经根丛病变（糖尿病性肌萎缩）具有相似且看似平行的症状学表现。后两种情况有潜在的微血管炎病理基础，免疫调节治疗已显示出潜在（但未经证实）的改善作用。这些观察结果促使我们用静脉注射甲泼尼龙治疗因疱疹后节段性轻瘫导致左下肢近端严重无力的患者。在本病例报告中，我们详细概述了该疾病的临床和电生理表型，并展示了此前持续三个月未改善的左腿力量出现的显著改善。在讨论部分，我们回顾了水痘-带状疱疹病毒的血管侵袭性。
