Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster

An 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematous, crusted, vesicular eruption distributed along the C3-C5 dermatome. Chest x-ray and computed tomography during inspiration and expiration demonstrated an elev...

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Main Author: Yasuhiro Kano
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:American Journal of Medicine Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667036425000020
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author Yasuhiro Kano
author_facet Yasuhiro Kano
author_sort Yasuhiro Kano
collection DOAJ
description An 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematous, crusted, vesicular eruption distributed along the C3-C5 dermatome. Chest x-ray and computed tomography during inspiration and expiration demonstrated an elevation of the left hemidiaphragm with almost no movement of the left diaphragm during respiration. These findings were consistent with left diaphragmatic paralysis due to cervical herpes zoster. As a rare type of segmental motor paresis, cervical herpes zoster can cause phrenic nerve paralysis because the phrenic nerve originates in the anterior horn of the C3 to C5 roots. Diaphragmatic paralysis results in diminished vital capacity and can lead to a decline in exercise tolerance or daily activity, especially in elderly patients.
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series American Journal of Medicine Open
spelling doaj-art-a2a8c49337fb4c0997d07b0f296de0212025-08-20T03:26:39ZengElsevierAmerican Journal of Medicine Open2667-03642025-06-011310008810.1016/j.ajmo.2025.100088Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes ZosterYasuhiro Kano0Requests for reprints should be addressed to Yasuhiro Kano, MD, Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan.; Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, JapanAn 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematous, crusted, vesicular eruption distributed along the C3-C5 dermatome. Chest x-ray and computed tomography during inspiration and expiration demonstrated an elevation of the left hemidiaphragm with almost no movement of the left diaphragm during respiration. These findings were consistent with left diaphragmatic paralysis due to cervical herpes zoster. As a rare type of segmental motor paresis, cervical herpes zoster can cause phrenic nerve paralysis because the phrenic nerve originates in the anterior horn of the C3 to C5 roots. Diaphragmatic paralysis results in diminished vital capacity and can lead to a decline in exercise tolerance or daily activity, especially in elderly patients.http://www.sciencedirect.com/science/article/pii/S2667036425000020Diaphragmatic paralysisHerpes zosterSegmental motor paresis
spellingShingle Yasuhiro Kano
Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
American Journal of Medicine Open
Diaphragmatic paralysis
Herpes zoster
Segmental motor paresis
title Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
title_full Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
title_fullStr Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
title_full_unstemmed Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
title_short Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster
title_sort tracing the rash diaphragmatic paralysis following cervical herpes zoster
topic Diaphragmatic paralysis
Herpes zoster
Segmental motor paresis
url http://www.sciencedirect.com/science/article/pii/S2667036425000020
work_keys_str_mv AT yasuhirokano tracingtherashdiaphragmaticparalysisfollowingcervicalherpeszoster