Citations 3
L5 Motor Paresis and Foot Drop Following Herpes Zoster Reactivation: An Unusual Presentation and Diagnostic Challenge in an Immunocompetent Patient - A Case Report
Romero, Tachy V. Hernandez, Ahmad, Ridwan , Orasma, Carlos A. Ruiz, Carcamo, Zulma D Sosa , Elwasila, Sammer M , Munipalli, Bala , Iftikhar, Salma , Gonzalez, Hector A. Robles, Dimberg, Elliot L., Alvarado, Joan M Irizarry , Rosales, J. Calvo , Hernandez Romero, Tachy V, Sosa Carcamo, Zulma D, Robles Gonzalez, Hector A, Irizarry Alvarado, Joan M , Cardenas Rosales, Juan Carlos , Orasma, Carlos Ruiz
Journal of Primary Care & Community Health | June 12, 2026 | Volume: 17 | Issue: No issue available | Pages: No page available
This is the case of a 67-year-old immunocompetent Hispanic male residing in Mexico who presented with acute right lower back and right lateral thigh pain. Initial imaging was unremarkable. He later developed painful vesicular lesions on the right foot and buttock. He was diagnosed with herpes zoster and initiated acyclovir and gabapentin. Ten days later, he developed foot drop, leg weakness, and urinary incontinence. Magnetic resonance imaging (MRI) showed enhancement of the cauda equina, and electrodiagnostic studies demonstrated right lumbar polyradiculopathy. The patient improved significantly with pain medications and physical therapy. After 8 months of physical therapy, he demonstrated significant clinical improvement. This case highlights the uncommon presentation of motor involvement in herpes zoster and emphasizes the role of imaging and electrophysiology in guiding diagnosis and management.
Development of a Preoperative Physical Frailty-associated Screening Process
Alvarado, Joan M Irizarry, Craver, Emily C. , Munipalli, Bala, Perusina, Jhonny, Irizarry, Angela C. , Pitruzzello, Nancy E, Ebeltoft, Kari E, Probst, Wende M, Friedman, Jesse R Forshey, Villorente, Genesis, Malavet, Pedro, Mitri, Ghada, Bader, Angela M, Irizarry Alvarado, Joan M , Forshey Friedman, Jesse R, Alvarado, Joan M Irizarry , Blitz, Jeanna D. , Bader, Angela M.
International Anesthesiology Clinics | May 12, 2026 | Volume: 64 | Issue: 3 | Pages: 8-14
Improving satisfaction with postoperative pain management for patients with persistent pain: a preoperative pain medicine consultation intervention
Mazer, Laura S, Lovett, Pamela J, Miller, Joanne M. , Pitruzzello, Nancy E, Boone, Margaret K., Alvarado, Joan M Irizarry , Irizarry Alvarado, Joan M
Journal of Perioperative Practice | November 7, 2019 | Volume: 30 | Issue: 11 | Pages: 345-351
Purpose Preoperative pain medicine consultations with opioid-tolerant patients allow for an accurate medication history, patient involvement in the postoperative plan, and realistic goal setting. The purpose of this quality improvement project was to increase attendance at preoperative pain consultations, thereby increasing patient satisfaction. Methods Retrospective chart reviews identified patients who had a preoperative pain consultation ordered from May through July 2016. Patient interviews determined reasons for not attending appointments, involvement in goal setting, engagement in pain management planning, and satisfaction with postoperative pain management. Results Retrospective chart reviews and interviews were conducted after the intervention (May–July 2017). Scheduling changes increased attendance at preoperative pain consultations by 14 percentage points (50% vs 64%). Those who attended consultations were more involved in goal setting and decisions and were more satisfied. Conclusions Preoperative pain consultations with opioid-tolerant patients can increase satisfaction through realistic goal setting and involvement in the pain management plan.