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Three-dimensional Imaging of Nociceptive Intraepidermal Nerve Fibers in Human Skin Biopsies
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Imaging Findings in Patients with Zoster-Associated Plexopathy.
A S Zubair1, C Hunt2, J Watson3,4
1From the Mayo Medical School (A.S.Z.).
AJNR. American Journal of Neuroradiology
|April 2, 2017
Summary
Herpes zoster can cause limb paresis due to zoster-associated plexopathy. MR imaging is useful for diagnosis, showing abnormalities like denervation changes and nerve T2 signal hyperintensity in most patients.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Herpes zoster, a reactivation of varicella zoster virus, can lead to complications such as limb paresis.
- Zoster-associated limb paresis, specifically due to plexopathies, has limited documented clinical and imaging features.
Purpose of the Study:
- To describe the clinical and imaging features of zoster-associated plexopathy.
- To evaluate the utility of MR imaging in diagnosing this condition.
Main Methods:
- Retrospective review of Mayo Clinic patient data from January 1996 to September 2012.
- Inclusion criteria: diagnosis of herpes zoster with limb paresis or MRI obtained.
- Analysis of imaging findings in ten identified cases of zoster-associated plexopathy.
Main Results:
- 70% of patients with zoster-associated plexopathy showed imaging abnormalities on MRI.
- Most frequent findings included secondary denervation changes in shoulder girdle muscles and nerve T2 signal hyperintensity (50%).
- Nerve enlargement was observed in 20% of cases; enhancement was absent in all cases despite early imaging.
Conclusions:
- MR imaging is clinically useful for confirming the diagnosis of zoster-associated plexopathy.
- Imaging findings can help identify secondary denervation and nerve signal changes characteristic of the condition.
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