Anesth Pain Med.  2016 Jan;11(1):76-79. 10.17085/apm.2016.11.1.76.

Diagnosis of diaphragmatic paralysis using ultrasound in a cervical herpes zoster patient: A case report

• Kim YY
• Kim YS
• Park SH

• KMID: 2169079
• DOI: http://doi.org/10.17085/apm.2016.11.1.76

Abstract

Herpes zoster is a varicella-zoster virus reactivation that is characterized by pain and rash. It can cause motor paresis on affecting muscles, but diaphragmatic paralysis is a rare complication. Methods of evaluation of diaphragmatic paralysis include plain radiography, fluoroscopy and electroneurography. The direct movement of diaphragmatic muscles on ultrasound can also be used to diagnose diaphragmatic paralysis. We reported a case of a 72-year-old woman who developed left hemidiaphragmatic paralysis after herpes zoster. The diaphragmatic paralysis occurred 3 weeks after appearance of a typical skin rash on the left C4-5 dermatomes. We diagnosed diaphragmatic paralysis using ultrasound.

Keyword

Diaphragm; Herpes zoster; Paralysis; Ultrasonography

MeSH Terms

Aged
Diagnosis*
Diaphragm
Exanthema
Female
Fluoroscopy
Herpes Zoster*
Herpesvirus 3, Human
Humans
Muscles
Paralysis
Paresis
Radiography
Respiratory Paralysis*
Ultrasonography*

Figure

• 

  Fig. 1 Scarred herpetic skin lesion.

• 

  Fig. 2 Chest X-ray shows marked elevated left diaphragm in full inspiration state.

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  Fig. 3 M-mode ultrasound trace during deep breath. (A) Right hemidiaphragm, normal movement, (B) Left hemidiaphragm, absent movement.

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