RESUMO
Segmental zoster paresis (SZP) is a rare complication of herpes zoster (HZ) that results in focal weakness of the extremity in the myotome that corresponds to dermatomal involvement.We present a case of an 80-year-old female with a resolving HZ rash on her left leg and buttocks that presented with left leg weakness for two weeks. The patient's rash preceded the left leg weakness by two weeks. The exam revealed erythematous macular and crusting lesions in the left L3/L4 distribution. The left thigh was flaccid with 1/5 knee extension strength with an absent patellar reflex. Lumbar spine magnetic resonance imaging (MRI) revealed enhancement of the left L4 roots, suggestive of inflammation or neuropathy. The patient was discharged on gabapentin, amitriptyline, and a two-week prednisone taper. In this case study, we present SZP, a rare complication that occurs in approximately 3% of HZ patients. The majority of SZP cases occur on the face or upper extremity, whereas our patient had SZP of the lower extremity. This case emphasizes the importance of maintaining a comprehensive differential diagnosis and highlights that SZP should be considered in patients who present with acute weakness in an extremity.
RESUMO
Selective medical perspectives of pediatric sports medicine are explored in this issue and behavioral perspectives of pediatric sports medicine are discussed in a subsequent journal issue. Concepts are considered now dealing with sports readiness involving the child and adolescent that involve understanding the limits imposed by growth and development at different ages as well as pubertal stages. Specializing in one sport too soon is not recommended. Sports readiness also involves understanding and counseling about proper diet and nutrition for maximum sports activity as well as overall health benefits. As clinicians understand sports readiness they can provide a beneficial pre-participation sports examination and deal with qualifications for sports play. Various medical conditions arise in dealing with pediatric persons involved in sports and these are considered in this discussion. They include the female athlete triad, iron deficiency anemia, sports anemia, musculoskeletal overuse injuries, obesity, sudden cardiac death, return to learning after sports-related concussion, epilepsy, asthma, diabetes mellitus, gastrointestinal disorders, genitourinary disorders and dermatology disorders in sports. Clinicians can be very helpful to these young athletes and work with them to ensure the full benefits of sport activities.