• Jun Young Kim, Jong-Moon Hwang, Jin-Sung Park, Sungwon Park, Byung Joo Lee, and Donghwi Park.
• Department of Dermatology.
• Medicine (Baltimore). 2019 Aug 1; 98 (31): e16694.

RationaleAlthough most complications of herpes zoster (HZ) are associated with the spread of varicella-zoster virus from the initially involved sensory ganglion, motor nerve impairment, such as limb weakness, is a rare but severe complication that is difficult to treat.Patient ConcernA 73-year-old female presented with sudden left upper limb pain and weakness after HZ.DiagnosisBrachial plexopathy following HZ (postherpetic brachial plexopathy).InterventionDespite alleviation of the vesicles with antiviral treatments, the left upper limb weakness and neuropathic pain did not improve. After obtaining patient's consent, ultrasound-guided polydeoxyribonucleotide (PDRN) injection was performed around the left brachial plexus.OutcomesThe patient showed marked improvement in left arm pain from numerical rating scale (NRS) 9 to 4, 1 day after PDRN injection. Subsequently, the pain improved to NRS 3, and motor weakness improved to Medical Research Council grade 2 to 4.LessonsPDRN can be considered a viable substitute for corticosteroid injection in treatment of motor weakness and neuropathic pain after HZ.

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