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Year : 1977  |  Volume : 11  |  Issue : 1  |  Page : 59-65

The Diagnosis Of Zoster Paralysis By A Serological Method With Special Reference To Zoster Sine Herpete



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S. K Gupta


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The diagnosis of Herpes zoster is obvicus in the presence of its characteristic vesicular eruptions. A condition presenting with the symptoms and signs highly suggestive of zoster but without the rash, had been recorded previously and termed “zona fruste” by Widal (1907) and “zoster sine herpete” by Weber (1916). Painful muscle paralysis due to zoster sine herpete was described by Lewis (1958). He did not, however, have any serological or virological evidence of varicella-zoster virus infection. In orthopaedic practice, cases of painful paralysis of the trunk and extremities are occasionally seen. In most of these cases, the etiology remains a mystery. Neuralgic amyotrophy (acute brachial neuritis) was such a condition described by Spillane (1943). Parsonage and Turner (1948) also described a syndrome comprising of pain and flaccid paralysis of the shoulder girdle muscles. They considered hospitalization, operations, infections, serum injections and trauma as some of the precipitating causes of the paralysis. Johnson and Kendall (1961) reported cases of sudden onset of isolated paralysis of the long thoracic nerve of Bell, circumflex nerve and accessory nerve, without recognizable cause of the paralysis. Zoster paralysis has characteristic segmental pain with sclerotomal and or dermatomal distribution (Lewis 1958). Without the rash, the diagnosis becomes difficult. We have endeavoured to define the clinical syndrome and applied a serological method to confirm it.


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