Herpes zoster sciatica mimicking lumbar canal stenosis: a case report

Area of Science:

• Neurology
• Dermatology
• Spinal Surgery

Background:

• Sciatica symptoms can be challenging to differentiate from herpes zoster.
• Spinal diseases such as lumbar disc herniation and spinal canal stenosis are common causes of sciatica.

Observation:

• A 74-year-old male presented with left-sided sciatic pain, initially diagnosed as spinal canal stenosis.
• The patient later developed a vesicular rash on his foot, consistent with herpes zoster in the L5 dermatome.

Findings:

• Magnetic resonance imaging confirmed lumbar spinal canal stenosis.
• Diagnosis of herpes zoster was made based on clinical presentation, including pain and rash characteristics.
• Treatment with famciclovir and NSAIDs led to symptom resolution.

Implications:

• Herpes zoster should be considered in the differential diagnosis of sciatica, even without an initial skin rash.
• Prompt diagnosis and antiviral treatment are crucial for managing herpes zoster presenting as sciatica.
• This case highlights the importance of considering infectious causes in patients with persistent or atypical sciatica.