Shingles/Motor Deficits (Full Version)

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orthotherapist -> Shingles/Motor Deficits (August 2, 2007 10:38:00 AM)

Have a patient that had shingles in May and now presents with postherpatic neuralgia.  She has both sensory and motor deficits (essentially ulnar nerve distribution)

Can shingles cause motor deficits?




Dr.Wagner -> RE: Shingles/Motor Deficits (August 2, 2007 1:11:40 PM)

Yes...if a peripheral nerve is involved...not common at all.  Most commonly it affects posterior horn cells of spinal ganglia or sensory portions of cranial nerves.

You can also develop herpetic meningitis.

Remember, these are not common manifestations...but it is a virus and they can do WHATEVER they want.



orthotherapist -> RE: Shingles/Motor Deficits (August 2, 2007 1:54:21 PM)

What is prognosis for motor return?  What is treatment?



Dr.Wagner -> RE: Shingles/Motor Deficits (August 3, 2007 9:01:32 AM)

Motor deficits, if they return, are as predictible as sensory neuralgia. Sometimes this can last a LONG time.   And because it is POST HERPETIC...treatment is iffy.  All herpetic illnesses are treated initially with Acyclovir (or valacyclovir, or famvir etc) plus/minus steroids.  Post herpetic neuralgia can be treated with Gabapentin or narcotic analgesia.
The motor deficit...if I was the doc...requires a neurology follow up.  Just to "make sure".



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