Article

Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently
reported, but there has been no report describing HZ-induced trunk muscle paresis
leading to functional problems. We describe a 73-year-old man with T12 and L1
segmental paresis caused by HZ presenting with abdominal wall pseudohernia,
scoliosis, and standing and gait disturbance who responded well to a systematic
rehabilitation approach. He first noticed a right abdominal bulge in the 6th
postherpetic week, which was gradually accompanied by right convex thoracolumbar
scoliosis, pain, and standing and gait disturbance in the 12th week. Needle
electromyography revealed abnormal spontaneous activities at rest in the right
T12 myotomal muscles, and motor unit recruitment was markedly decreased. We
arranged an outpatient rehabilitation program consisting of using a soft
thoracolumbosacral orthosis for pain relief and trunk stability, muscle
reeducation of the paretic abdominal muscles, strengthening of the disused trunk
and extremity muscles, and gait exercise. Based on electromyographic findings, we
instructed him in an effective method of muscle reeducation. After 4 months of
rehabilitation, he showed marked improvement and became an outdoor ambulator. We
suggest that electromyography is a useful tool to evaluate clinical status and
devise an effective rehabilitation program in patients with HZ trunk paresis.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS