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Lumbar hernia following herpes zoster
Military Hospital Jabalpur Cantonment., (M.P) 482 001
|How to cite this article:
Baveja S, Sharma Y K, Rao P R. Lumbar hernia following herpes zoster. Indian J Dermatol Venereol Leprol 2003;69:21
AbstractLumbar hernia as a complication of herpes zoster is exceedingly rare. Herein we report a case who developed lumbar hernia following herpes zoster T 10, 11 dermatome.
Herpes zoster is primarily a disease of dorsal root ganglion of sensory nerves or extramedullary ganglion of cranial nerves. The occurrence of motor deficit varies from 0.5 to 31 percent and is more common in the elderly. Lumbar hernia following weakness of the anterior abdominal wall affected by herpes zoster is extremely rare. In the present communication we document one such case.
A 55-year-old patient presented with complaint of painful fluid filled rash on right side of abdomen and back of four days duration. Examination revealed multiple grouped tense vesicles on an erythematous base in right T 10 and 11 dermatome. On the seventh day of illness he developed constipation which was partially relieved with laxatives and three days thereafter noticed a diffuse swelling in the affected dermatome, which gradually increased in size over next two days and became static thereafter. Swelling was non tender, reducible and became prominent on straining [Figure - 1]. Abdominal wall movements on the affected side were reduced. He was diagnosed to have lumbar hernia which necessitated surgical repair [Figure - 2].
Herpes zoster may rarely involve the motor neurones leading to paresis/paralysis of muscles supplied by the affected segment(s). Motor affection of facial nerve is the commonest. Less commonly paralysis of ocular muscles, trunk muscles, diaphragm, bladder and bowel may occur. To the best of our knowledge only one case of lumbar hernial has been reported following herpes zoster of T10, 11 dermatome. In our case also hernia occurred following weakness of abdominal wall affected by herpes zoster. Despite successful repair of the hernia, chances of recurrence are there due to residual weakness of the affected abdominal musculature.