Herpes Zoster Ophthalmicus With Contralateral Hemiplegia

Abstract

Introduction Herpes zoster ophthalmicus associated with contralateral hemiplegia, with or without ipsilateral brain stem involvement, and without other signs of a more generalized encephalitis, is a clinical event of such rarity that only seven valid case reports exist in the world literature. This communication reports two additional cases with a brief summary of the clinical manifestations of herpes zoster involvement of the central nervous system, in particular the cranial nerves. Herpes zoster involvement of the central nervous system presents in general four different clinical syndromes. These are: as a mononeuritis, as a myelitis, a diffuse meningo-encephalitis, and the least common syndrome of hemiplegia associated with herpes zoster ophthalmicus in the absence of the other usual signs of a more diffuse encephalitis (Table 1). Summary of Previous Case Reports The first case report by Dumery in 1896, herpes zoster ophthalmicus with contralateral hemiplegia, cited by Cope,⁵ describes the onset