Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster

Introduction. Herpetic lesion of the phrenic nerve is quite uncommon. These lesions are usually unilateral, and for most clinicians, the clinical manifestation of herpes zoster in the cervical or thoracic region and diaphragmatic paralysis on the same side is sufficient for making a diagnosis of seg...

Full description

Saved in:
Bibliographic Details
Main Authors: Martić Vesna, Stojanov Aleksandar
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2023-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300001M.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850158037498593280
author Martić Vesna
Stojanov Aleksandar
author_facet Martić Vesna
Stojanov Aleksandar
author_sort Martić Vesna
collection DOAJ
description Introduction. Herpetic lesion of the phrenic nerve is quite uncommon. These lesions are usually unilateral, and for most clinicians, the clinical manifestation of herpes zoster in the cervical or thoracic region and diaphragmatic paralysis on the same side is sufficient for making a diagnosis of segmental herpes zoster phrenic nerve palsy. We report a patient with a classic clinical picture, in which we confirmed phrenic nerve affection on nerve conduction study. Case report. A 58-year-old female patient came for an examination due to shortness of breath. The patient had a herpetic rash on her right shoulder two and a half months earlier. The elevation of the right hemidiaphragm was seen on chest X-ray imaging. Asymmetry was evident in the nerve conduction study of the phrenic nerve: prolonged latency and reduced amplitude of her right phrenic nerve. The patient was treated with acyclovir, pregabalin, and B complex vitamins. After six months, the motor deficit was reduced completely. Conclusion. A nerve conduction study of the phrenic nerve is useful in making the definitive diagnosis. Good outcome, as in this patient, is rare in patients with this diagnosis and may be linked to timely treatment with acyclovir.
format Article
id doaj-art-5fc0df4142834cd1af6ae04d380026ec
institution OA Journals
issn 0042-8450
2406-0720
language English
publishDate 2023-01-01
publisher Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
record_format Article
series Vojnosanitetski Pregled
spelling doaj-art-5fc0df4142834cd1af6ae04d380026ec2025-08-20T02:24:00ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202023-01-0180980280410.2298/VSP200511001M0042-84502300001MNeurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zosterMartić Vesna0Stojanov Aleksandar1https://orcid.org/0000-0002-6462-3528Military Medical Academy, Clinic for Neurology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity Clinical Center Niš, Clinic for Neurology, Niš, SerbiaIntroduction. Herpetic lesion of the phrenic nerve is quite uncommon. These lesions are usually unilateral, and for most clinicians, the clinical manifestation of herpes zoster in the cervical or thoracic region and diaphragmatic paralysis on the same side is sufficient for making a diagnosis of segmental herpes zoster phrenic nerve palsy. We report a patient with a classic clinical picture, in which we confirmed phrenic nerve affection on nerve conduction study. Case report. A 58-year-old female patient came for an examination due to shortness of breath. The patient had a herpetic rash on her right shoulder two and a half months earlier. The elevation of the right hemidiaphragm was seen on chest X-ray imaging. Asymmetry was evident in the nerve conduction study of the phrenic nerve: prolonged latency and reduced amplitude of her right phrenic nerve. The patient was treated with acyclovir, pregabalin, and B complex vitamins. After six months, the motor deficit was reduced completely. Conclusion. A nerve conduction study of the phrenic nerve is useful in making the definitive diagnosis. Good outcome, as in this patient, is rare in patients with this diagnosis and may be linked to timely treatment with acyclovir.https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300001M.pdfdiagnosiselectrodiagnosisherpes zosternerve conduction studiesphrenic nerve
spellingShingle Martić Vesna
Stojanov Aleksandar
Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
Vojnosanitetski Pregled
diagnosis
electrodiagnosis
herpes zoster
nerve conduction studies
phrenic nerve
title Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
title_full Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
title_fullStr Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
title_full_unstemmed Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
title_short Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
title_sort neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster
topic diagnosis
electrodiagnosis
herpes zoster
nerve conduction studies
phrenic nerve
url https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300001M.pdf
work_keys_str_mv AT marticvesna neurophysiologicalconfirmationofphrenicnerveaffectioninapatientwithdyspneaandherpeszoster
AT stojanovaleksandar neurophysiologicalconfirmationofphrenicnerveaffectioninapatientwithdyspneaandherpeszoster