[A case of diaphragmatic paralysis following herpes zoster]

We report a case of diaphragmatic paralysis after herpes zoster. A 82-year-old woman developed shortness of breath on effort after about two months of a typical herpes zoster eruptions affecting the C4 and C5 dermatomic areas on the right side. A chest x-ray showed an elevated right diaphragm. The diaphragmatic evoked potential by stimulation of the right phrenic nerve at the posterior border of the sternocleidomastoid muscle was not elicited. Chest CT and cervical MRI were normal. The viral antibody titers of herpes zoster were elevated in the serum. Cervical herpes zoster should be considered as a possible cause of hemidiaphragmatic paralysis.