Motor radiculopathy caused by varicella zoster virus without skin lesions ('zoster sine herpete').

摘要

About 5% of all patients with herpes zoster develop some form of motor weakness in a myotomal distribution ('segmental zoster paresis') [1]. We report on a patient who presented with a motor radiculopathy due to varicella zoster virus (VZV) in absence of herpes zoster ('zoster sine herpete'). A 77-year-old woman presented herself with a three weeks' history onset of sciatica and right footdrop. She was diagnosed with B-cell chronic lymphocytic leukemia (CLL) 13 years ago and had been treated with a chemotherapy regimen consisting of chloram-bucil in 2001 and fludarabine/cyclophosphamide in 2006, resulting in stable disease. On neurological examination there was muscle weakness in the right tibialis anterior (4/5), tibialis posterior (3/5) and extensor hallucis longus (2/5). Knee and ankle jerks were normal. There were no sensory abnormalities.