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Andrew M. Ball, MS, PT -> Re: Herpes Zoster and muscle weakness (June 18, 2001 6:42:00 AM)
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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
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