Herpes Zoster and muscle weakness

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Herpes Zoster and muscle weakness

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Herpes Zoster and muscle weakness - June 16, 2001 4:40:00 AM

jma

Posts: 2414
Joined: August 24, 2000
From: NY
Status: offline

Hello,
I have come across a patient that is recovering from herpes zoster and has a complaint with unilateral leg weakness. I looked over the Merck manual and found that on rare occassions, does this virus cause muscle weakness and neuralgia. I found the patients ROM extremely limited due to pain and poor MMS strength for the same reason. I read in one of my books that no heat or ultrasound should not be used for these patients. Besides using isometrics for increasing strength initially, what else can be done to decrease the pain? I have read that this can last for months and years, according to the Merck Manual. Any tips or references will be appreciated.

Post #: 1

Re: Herpes Zoster and muscle weakness - June 18, 2001 7:42:00 AM

Andrew M. Ball, MS, PT

Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
Status: offline

The Merck Manual is good for reviewing the basics of Herpes Zoster and what you may see clinically, but is the incorrect resource for answering your question.

MEDLINE, MEDLINE, MEDLINE

It's free, so there's no excuse for not using it.

The NIH MEDLINE portal (PubMed actually, which includes pre-medline material) can be accessed at:
[URL=http://www.ncbi.nlm.nih.gov/PubMed/]http://www.ncbi.nlm.nih.gov/PubMed/[/URL]

Using the search string:

"Herpes Zoster" AND muscle

you will generate 106 hits, that's too much

to refine the string:

"Herpes Zoster" AND muscle AND weak

You will generate 2 hits

The one from 1976 is a case series of 18 patients, 14 of whom had LMN impariments, as well as suggestions for how to structure your therapy. The other is from 1996 and retropectively examines 104 patients there you will find how often functional motor recovery occurs, and in what time frame. It goes into typical perepheral nerves affected too.

As for your assertion that heat and US are contraindicated, I'd review the following information:

Walker E. Ultrasound therapy for herpes zoster pain. J R Coll Gen Pract. 1984 Nov;34(268):627-8.

Payne C. Ultrasound for post-herpetic neuralgia. A study to investigate the results of treatment. Physiotherapy 1984 Mar;70(3):96-7

Jones RJ, Silman GM. Trial of ultrasonic therapy for acute herpes zoster. Practitioner 1987 Oct 8;231(1436):1336-40

I look forward to your review of the literature regarding this topic, and your assessment of how it can be applied to your specific case. Please update us once you have done so.

Drew

(in reply to jma)

Post #: 2

Re: Herpes Zoster and muscle weakness - May 23, 2002 12:26:00 PM

amelia

Posts: 11
Joined: April 3, 2002
Status: offline

TENS is a wonderful thing to use for post neuralgic pain, tried it yet?

(in reply to jma)

Post #: 3