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Issue: October 1, 2006
Case: Neuropathy
Taken from
Med-Challenger EM Career
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Question:
All of the following are true regarding herpes zoster
EXCEPT:
Answer Options:
- Treatment consists of analgesics, acyclovir, and steroids. The benefit of
acyclovir and steroids in helping to reduce the risk of postherpetic
neuralgia is significantly increased if started within 72 hours.
Immunocompromised patients are often admitted for IV acyclovir.
- Though usually an isolated phenomenon, it may be associated with
immunocompromise, diabetes mellitus, or stress.
- Unilateral dermatomal pain or paresthesia may precede the painful
dermatomal vesicular eruption by 2-3 days.
- Ophthalmic involvement requires urgent ophthalmologic consultation.
- Tongue, external ear canal, and tympanic membrane involvement may occur
in the Ramsay Hunt syndrome (sensory seventh nerve).
- Motor dysfunction rules out the diagnosis.
Answer:
F
Remediation:
Segmental motor
paresis occurs in 3% of patients. Ganglion blockade may be
beneficial with ophthalmic nerve involvement.
About the Image(s):
Image 1:
76-year-old Male with Zoster
This 76-year-old male with zoster presented with 2 days of
right-sided chest pain and the rash seen here.
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