Is Herpes Zoster Merely A Simple Neuralgia Syndrome?

Abstract

Aim: Although, herpes zoster usually presents with postherpetic neuralgia (PHN) localized at single dermatome, it may also manifest with different clinical presentations. To clarify of these rare conditions, we aimed to examine the cases of PHN followed by our clinic in more details. Method: Medical records of 26 patients in total monitored by the neurology outpatient clinic for PHN between 2008 and 2010 were reviewed.Result: The mean age of the patients was 61.9±16.4 years, with a female-male ratio of 15/11. Ten of the patients (38 %) had a chronic illness history such as solid cancer, lymphoma, diabetes mellitus, cardiac valve prosthesis and Parkinson’s disease. Eight of the patients had trigeminal nerve lesions (ophthalmic in 7 and mandibular in 1), 3 had spinal cervical lesions, 8 had spinal thoracic lesions and 7 had spinal lumbar dermatomic lesions. Three (11.5%) patients had motor involvement (C7 in one and L4-L5 innervated muscles in two). Four patients (15.3%; symmetric sides of the same dermatome in two and at different dermatomes in another two) had multiple dermatomal involvements.Conclusion: Immunosuppression and advanced ages are known to facilitate varicella reactivation. By reviewing patients with zona zoster monitored by our clinic for accompanying conditions, anatomical localizations and presence of multiple dermatomal involvements, the present study emphasizes that zona may also cause ‘motor involvement’ besides sensory involvement. Our findings demonstrate that zona is a complex syndrome which may manifest as varying clinical presentations.