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- W1598965167 abstract "To the Editor:Slow conducting unmyelinated, afferent fibers can mediate in addition to pain many physiological responses from a sustained increase in breathing [1,2] or blood pressure [3] via skeletal muscle afferents [4] to a rapid shallow breathing pattern triggered by pulmonary C fibers [5]. Stimulation of the same type of afferent fibers located in the diaphragm [6,7] has been proposed as a cause of shortness of breath [8] during an increased work of breathing, diaphragmatic “ischemia” or fatigue [7,9,10]. The resulting sensory information travels through the phrenic nerves to the cervical dorsal roots reaching the lateral spino-thalamic tract and ultimately the limbic cortex [11]. This is analogous to how unmyelinated fibers in the skin and viscera mediate the transmission of painful information [12]. There is very little clinical information available to estimate the relevance of this mechanism owing to the coexistence of many factors contributing to dyspnea in a given patient. The purpose of this letter is twofold: 1) present a previously under-recognized cause of dyspnea associated with neck pain secondary to herpes zoster of the right C3-C5 dermatomes and 2) describe the method we used to address the putative role of unmyelinated diaphragmatic afferent fibers in the genesis of dyspnea and the link between the shortness of breath and the herpetic pain experienced by this patient.We present the case of a previously healthy 61-year-old woman, with no prior medical history. Of note, she previously engaged in daily exercise with no complaints. During her initial visit, she complained of severe dyspnea at rest and on exertion in association with the onset of a typical blistering painful rash of herpes zoster affecting the right C3-C5 sensory dermatomes beginning 2 weeks previously (the right lateral and posterior regions of the neck down to the scapula).Her …" @default.
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- W1598965167 date "2012-09-01" @default.
- W1598965167 modified "2023-10-18" @default.
- W1598965167 title "Neck Pain and Dyspnea: Lessons from a Patient with Zoster" @default.
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- W1598965167 doi "https://doi.org/10.1111/j.1526-4637.2012.01425.x" @default.
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