Clinical, electrophysiologic, and imaging features of zoster-associated limb paresis

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19 Scopus citations


Introduction: Paresis is a long-recognized complication of herpes zoster, but there has been comparatively little study of zoster-associated limb paresis (ZALP). Methods: In this study we reviewed 49 Mayo Clinic patients with ZALP. Results: The mean age of onset was 71 years, 67% were men, and the lower limb was affected in 55%. The mean weakness score was 2.0 (0=normal strength, 4=plegia). Most patients developed postherpetic neuralgia (PHN, 92% at 1 month and 65% at 3 months), and the average minimum duration of weakness was 193 days. ZALP was caused by radiculopathy (37%), plexopathy (41%), mononeuropathy (14%), and radiculoplexus neuropathy (8%). MRI demonstrated nerve enlargement, T2 signal prolongation, or enhancement in a majority (64%) of affected plexi and peripheral nerves. Conclusions: ZALP is associated with considerable weakness. It typically lasts at least several months, localizes to plexus or peripheral nerve in 63%, and is associated with high rates of PHN.

Original languageEnglish (US)
Pages (from-to)177-185
Number of pages9
JournalMuscle and Nerve
Issue number2
StatePublished - Aug 2014


  • Herpes zoster
  • Infectious neuropathy
  • Postherpetic neuralgia
  • Zoster paresis
  • Zoster-associated limb paresis

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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