Naka Municipal Kaminaka Hospital, Japan.
Department of Neurology, University of Tokushima Graduate School of Biomedical Sciences, Japan.
Intern Med. 2023;62(18):2743-2746. doi: 10.2169/internalmedicine.0578-22. Epub 2023 Sep 15.
We herein report a 90-year-old immunocompromised woman who developed right upper limb weakness and right ptosis with a miotic pupil 1 week after oral therapy for zoster on the right T2 dermatome. The right pupil was dilated with instillation of 1% apraclonidine, indicating Horner's syndrome. The patient was treated with intravenous acyclovir and methylprednisolone. Focal weakness related to zoster, generally known as segmental zoster paresis, improved over five months, but Horner's syndrome remained. We suggest that aggressive intravenous treatment should be considered for rare cases of zoster that occur with a combination of these two neurological conditions.
我们在此报告一例 90 岁免疫功能低下的女性患者，在右侧 T2 皮节带状疱疹口服治疗 1 周后出现右上肢无力和右侧上睑下垂，伴有瞳孔缩小。右眼瞳孔在滴用 1%阿可乐定后扩大，提示霍纳氏综合征。患者接受了静脉用阿昔洛韦和甲泼尼龙治疗。与带状疱疹相关的局灶性无力，一般称为节段性带状疱疹性瘫痪，在 5 个月内逐渐改善，但霍纳氏综合征仍然存在。我们建议对于这两种神经疾病同时发生的罕见带状疱疹病例，应考虑积极的静脉治疗。
