Motor radiculopathy caused by varicella zoster virus without skin lesions (‘zoster sine herpete’)

Three weeks after onset of her symptoms needle electromyography (EMG) showed fibrillation potentials and positive waves in the tibialis anterior and posterior muscles, and the extensor hallucis longus muscle of the right leg, confirming the earlier, clinical diagnosis of the L5 radiculopathy. The work-up of a motor radiculopathy with normal MRI of the lumbosacral spine should include CSF analysis with PCR for VZV-DNA even in the absence of herpes zoster.