Anesth Pain Med.  2018 Apr;13(2):197-200. 10.17085/apm.2018.13.2.197.

Abdominal muscle paresis due to herpes zoster with hiatal hernia: A case report

• Lee JH
• Heo HJ
• Kim I
• Shin SI

• KMID: 2437429
• DOI: http://doi.org/10.17085/apm.2018.13.2.197

Abstract

Herpes zoster is an infectious disease of the dorsal root ganglion and sensory nerve fibers. Motor nerve involvement is a rare complication. Hiatal hernia occurs when the stomach protrudes into the thoracic cavity through the esophageal hiatus of the diaphragm. Herein, we present the case of a 78-year-old man with abdominal wall muscle paresis caused by herpes zoster, which resulted in a hiatal hernia.

Keyword

Abdominal muscles; Herpes zoster; Hiatal hernia; Paresis

MeSH Terms

Abdominal Muscles*
Abdominal Wall
Aged
Communicable Diseases
Diaphragm
Ganglia, Spinal
Hernia, Hiatal*
Herpes Zoster*
Humans
Nerve Fibers
Paresis*
Stomach
Thoracic Cavity

Figure

• 

  Fig. 1 Bulging appearance of the left flank.

• 

  Fig. 2 (A) Coronal and (B) axial enhanced abdominal computed tomography showing a mild sliding type hiatal gastric hernia (arrows).

Reference

1. Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007; 44(Suppl 1):S1–26. DOI: 10.1086/510206. PMID: 17143845.

2. Weiss S, Streifler M, Weiser HJ. Motor lesions in herpes zoster. Incidence and special features. Eur Neurol. 1975; 13:332–8. DOI: 10.1159/000114687. PMID: 1149753.

3. Roman S, Kahrilas PJ. The diagnosis and management of hiatus hernia. BMJ. 2014; 349:g6154. DOI: 10.1136/bmj.g6154. PMID: 25341679.

4. Broadbent WH. Case of herpetic eruption in the course of branches of the brachial plexus, followed by partial paralysis in corresponding motor nerves. Br Med J. 1866; 2:460. DOI: 10.1136/bmj.2.304.460. PMCID: PMC2310325.

5. Maeda K, Furukawa K, Sanada M, Kawai H, Yasuda H. Constipation and segmental abdominal paresis followed by herpes zoster. Intern Med. 2007; 46:1487–8. DOI: 10.2169/internalmedicine.46.0328. PMID: 17827858.

6. Chernev I, Dado D. Segmental zoster abdominal paresis (zoster pseudohernia): a review of the literature. PM R. 2013; 5:786–90. DOI: 10.1016/j.pmrj.2013.05.013. PMID: 24054853.

7. Lim HK, Park JH, Lee KH. Herpes zoster induced pure motor segmental paresis: a case report. Anesth Pain Med. 2012; 7:210–2.

8. Kim YY, Kim YS, Park SH. Diagnosis of diaphragmatic paralysis using ultrasound in a cervical herpes zoster patient: a case report. Anesth Pain Med. 2016; 11:76–9. DOI: 10.17085/apm.2016.11.1.76.

9. Kohn GP, Price RR, DeMeester SR, Zehetner J, Muensterer OJ, Awad Z, et al. Guidelines for the management of hiatal hernia. Surg Endosc. 2013; 27:4409–28. DOI: 10.1007/s00464-013-3173-3. PMID: 24018762.