Postherpetic neuralgia is the most commonly seen complication of herpes zoster, primarily in elderly and immunocompromised patients. However, motor involvement due to herpes zoster is very rare. A 65-year-old male patient presented with left leg pain, numbness and difficulty walking. He was diagnosed with having herpes zoster and treated with valacyclovir. Despite anti-convulsant and physical therapy, the patient developed foot drop and had an unexplained weight loss. Clinical and laboratory findings suggested previously undiagnosed diabetes mellitus. Three weeks after initiation of insulin treatment, he became normoglycemic, his pain was reduced, and foot drop disappeared almost completely. Postherpetic motor involvement as an unusual complication may signal an underlying systemic disease, particularly in elderly.
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http://dx.doi.org/10.5606/tftrd.2017.34603 | DOI Listing |
Cureus
December 2024
Orthopaedic Surgery, Ng Teng Fong General Hospital, Singapore, SGP.
This case report describes a 70-year-old male presenting with limb weakness, urinary retention and tandem cervical and lumbar spinal stenosis with complicating white cord syndrome, a rare reperfusion injury post decompression surgery. Initially admitted following an unwitnessed fall, the patient's neurological examination indicated that progressive weakness of the limbs and sensory loss etiology is cervical and lumbar spondylosis with severe spinal canal stenosis, confirmed by imaging. Due to rapid deterioration, he underwent C5 corpectomy, cervical decompression and fusion.
View Article and Find Full Text PDFJ Am Podiatr Med Assoc
January 2025
†Arbor-Ypsi Foot and Ankle Centers, Ann Arbor, Michigan.
This case report describes an otherwise healthy 43-year-old female who presented with severe pain, foot drop, and critical limb ischemia to her left foot caused by thrombosis of a peripheral artery secondary to antiphospholipid syndrome. Antiphospholipid syndrome is an autoimmune disease that frequently manifests as recurrent arterial and/or venous thrombotic events, ischemic strokes, and miscarriages. Antiphospholipid syndrome affecting primarily the arteries is less common as compared to venous thrombosis.
View Article and Find Full Text PDFInt Orthop
January 2025
Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
Entrapment neuropathies of the lower extremity are often underdiagnosed due to limitations in clinical examination and electrophysiological testing. Advanced imaging techniques, particularly MR neurography and high-resolution ultrasonography (US), have significantly improved the evaluation and diagnosis of these conditions by enabling precise visualization of nerves and their surrounding anatomical structures. This review focuses on the imaging features of compressive neuropathies affecting the lumbosacral plexus and its branches, including the femoral, obturator, sciatic, common peroneal, and tibial nerves.
View Article and Find Full Text PDFArch Bone Jt Surg
January 2024
Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Flail foot is a condition characterized by a significant weakness in ankle dorsiflexion, resulting in limited or no active mobility in the ankle. To address this issue, we described a novel approach called tenodesis, which has been developed for ankle joint stabilization. This technique utilizes the patient's tendons to minimize potential complications.
View Article and Find Full Text PDFBMJ Neurol Open
January 2025
Research Group experimental Neurosurgery and Neuroanatomy and the Leuven Brain Institute, KU Leuven, Leuven, Flanders, Belgium.
Objective: Diffusion tensor imaging (DTI) showed promising results in diagnosing upper limb neuropathies, but its value in patients with foot drop due to peroneal neuropathy has not yet been investigated. We aim to establish reference values for DTI metrics of the healthy peroneal nerve and to evaluate differences in DTI metrics between patients and healthy controls.
Methods: Diffusion-weighted images (DWI) from 22 pathological nerves, 14 asymptomatic patients' nerves and 65 healthy peroneal nerves were processed for quantitative assessment of fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity and mean diffusivity.
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