Abstract
Varicella zoster virus (VZV) lies dormant in our spinal dorsal root ganglia until reactivation occurs and causes herpes zoster. VZV can spread from the dorsal root to the neighboring ventral root and cause subsequent segmental paresis. In this case report, we present the case of a 78-year-old female who was hospitalized after she developed right upper extremity paresis and altered mental status four days after the eruption of a vesicular rash involving the same dermatome. The patient received intravenous acyclovir, gabapentin, and inpatient rehabilitation. She was found to have made a full recovery one year later. Pain and a vesicular rash is the most common presentation of VZV infection in the elderly. However, segmental zoster paresis should be suspected in any patient with paralysis and a recent diagnosis of herpes zoster.