Postherpetic Neuralgia Mimiking Renal Colic: Zoster Sine herpete with Segmental Thoracic Motor Paresis

Abstract

We describe a case of zoster sine herpete with a motor paresis mimicking a urolithiasis. A 54 year-old woman admitted for her flank pain in an emergency room. The computer tomography (CT) scans and her symptoms were similar to those caused by renal colic. A urology surgeon operated on her for a urolithiasis. However, her flank pain did not improve. She felt the allodynia and burning pain in the left T10-12 dermatomes. She also complained abdominal wall bulging in same lesion. She had no history of skin eruption and no scar of herpes zoster. The abdominal CT scan did not find any pathologic findings. Electromyelography showed denervation potential on some abdominal muscles. Serologic studies indicated that varicella-zoster virus IgG titers were positive. We concluded that this condition was zoster sine herpete. Fortunately, the patient responded well to our empirical therapy, which included gabapentin and epidural steroid injections.