Claw Hand Deformity: A Rare Complication of Herpes Zoster

Abstract

Tachit Jiravichitchai,1 Waree Chira-adisai,1 Monratta Panuwannakorn,1 Sasisopin Kiertiburanakul2 1Department of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Tachit JiravichitchaiDepartment of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Ramathibodi Hospital, Ratchathewi, Bangkok, ThailandTel/Fax [phone]Email [email protected]; [email protected]: Distal upper extremity weakness is a rare complication after herpes zoster, which can be easily misdiagnosed by other nerve entrapment syndromes. We present a 31-year-old immunocompromised woman who developed a claw-like deformity of her right hand after full medical treatment and resolution of herpes zoster. The electrodiagnostic finding was compatible with right multiple mononeuropathies of the median and ulnar nerves, ongoing axonal loss, unlike the nerve entrapment patterns. The early recognition and early electrodiagnosis of herpes zoster-induced distal motor weakness, especially in the upper extremity, is necessary to exclude the nerve entrapment syndrome and to be the baseline for functional motor recovery prediction. The prognosis of functional motor recovery is considered good but may take months to years to accomplish. Rehabilitation management plays an important role after full medical treatment.Keywords: herpes zoster, claw hand deformity, electrodiagnosis, rehabilitation, hand splint

Keywords

• herpes zoster
• claw hand deformity
• electrodiagnosis
• rehabilitation
• hand splint