Jiravichitchai Tachit, Chira-Adisai Waree, Panuwannakorn Monratta, Kiertiburanakul Sasisopin
Department of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Orthop Res Rev. 2021 Nov 17;13:209-214. doi: 10.2147/ORR.S339064. eCollection 2021.
Distal upper extremity weakness is a rare complication after herpes zoster, which can be easily misdiagnosed by other nerve entrapment syndromes. We present a 31-year-old immunocompromised woman who developed a claw-like deformity of her right hand after full medical treatment and resolution of herpes zoster. The electrodiagnostic finding was compatible with right multiple mononeuropathies of the median and ulnar nerves, ongoing axonal loss, unlike the nerve entrapment patterns. The early recognition and early electrodiagnosis of herpes zoster-induced distal motor weakness, especially in the upper extremity, is necessary to exclude the nerve entrapment syndrome and to be the baseline for functional motor recovery prediction. The prognosis of functional motor recovery is considered good but may take months to years to accomplish. Rehabilitation management plays an important role after full medical treatment.
上肢远端无力是带状疱疹后一种罕见的并发症，很容易被其他神经卡压综合征误诊。我们报告一名31岁的免疫功能低下女性，在带状疱疹经过充分治疗并痊愈后，右手出现爪形畸形。电诊断结果与右侧正中神经和尺神经多发性单神经病相符，存在持续性轴突丢失，与神经卡压模式不同。早期识别和早期电诊断带状疱疹引起的远端运动无力，尤其是在上肢，对于排除神经卡压综合征以及作为功能性运动恢复预测的基线至关重要。功能性运动恢复的预后被认为良好，但可能需要数月至数年才能实现。在充分药物治疗后，康复管理起着重要作用。
