Clinical ReportSegmental Zoster Paresis of Limbs Report of Three Cases and Review of LiteratureKawajiri, Sumihiro MD*; Tani, Momo MD*; Noda, Kazuyuki MD*; Fujishima, Kenji MD*; Hattori, Nobutaka MD†; Okuma, Yasuyuki MD*Author Information From the *Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan; and the †Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan. Reprints: Yasuyuki Okuma, MD, Department of Neurology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan. E-mail: [email protected]. The Neurologist: September 2007 - Volume 13 - Issue 5 - p 313-317 doi: 10.1097/NRL.0b013e31811e9d6d Buy Metrics Abstract Objectives: Segmental zoster paresis is a relatively rare complication characterized by focal motor weakness, which may occur in limbs affected by herpes zoster. We demonstrate the clinical characteristics of segmental zoster paresis by reviewing the cases of 138 patients, including 3 of our patients. Case Report and Review Summary: We report 3 patients with zoster paresis of the limbs. Patients 1 and 3 showed motor weakness in the left shoulder and arm after developing a herpetic rash in the left C5–C6 dermatomes. Patient 2 showed weakness in the right thigh and groin after a right L2–L3 herpetic eruption. The electromyograms of all 3 patients showed abnormal spontaneous activity in the affected muscles. Intravenous acyclovir and corticosteroid pulse therapy were added to oral antiviral drugs for patients 1 and 2. All 3 patients recovered favorably. Our review of the literature revealed that antiviral treatment may prevent the occurrence of zoster paresis; however, there is insufficient evidence to show what treatment hastens recovery from zoster paresis. Conclusions: Segmental zoster paresis is still underrecognized by neurologists. Awareness of this disorder is important because it may eliminate unnecessary invasive investigations and lead to appropriate treatment. Further studies on the treatment are necessary. © 2007 Lippincott Williams & Wilkins, Inc.