Herpes Zoster Infection Culminating in Abdominal Motor Paresis: A Case Report

Herpes zoster (HZ) results in numerous complications, the most prevalent being Post Herpetic Neuralgia (PHN). There are fewer than 40 case reports of motor paresis of abdominal muscles secondary to Herpes zoster (Phantom hernia) in the literature to date. The pathogenesis of motor involvement resulting from HZ includes polyneuritis and segmental motor neuropathy, accompanied by subsequent muscle denervation. The viral transmission from the dorsal root ganglion to the anterior horn cells and anterior spinal nerve roots, along with inflammatory involvement of the motor nerve, is believed to contribute to both axonal loss and demyelination. Pseudohernias represent a limited protrusion of the abdominal wall without an evident muscle or aponeurotic defect, secondary to a relaxation of the anterior abdominal wall and resultant bulging because of the intra-abdominal pressure. Here, we report a case of herpes zoster infection involving the T9-T10 dermatome presenting with phantom hernia, which resolved spontaneously within seven months. This case is being reported due to its rarity and highlights the significance of timely and accurate identification to avoid unnecessary evaluation and interventions.