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. 1985 Feb;48(2):122–127. doi: 10.1136/jnnp.48.2.122

Herpes zoster ophthalmicus followed by contralateral hemiparesis: report of two cases and review of literature.

E Reshef, S B Greenberg, J Jankovic
PMCID: PMC1028210  PMID: 3884741

Abstract

Two patients with herpes zoster ophthalmicus and contralateral hemiparesis are described, and their findings compared with 49 patients previously reported. These patients presented with delayed contralateral hemiparesis approximately seven weeks after the onset of herpes zoster ophthalmicus. Most patients had evidence of infarction of the ipsilateral middle cerebral artery by angiography or by CT scan. Cerebrospinal fluid pleocytosis and elevated protein commonly were found. Twenty per cent of the reported patients died, but they were older than the patients who survived and predisposed to have diffuse CNS lesions. The pathogenesis of this syndrome is thought to be due to direct viral invasion of the blood vessel wall with resulting angiitis. Further studies need to be performed to clarify the role of specific antiviral therapy or anti-inflammatory agents in treating this complication of herpes zoster.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ACERS T. E. HERPES ZOSTER OPHTHALMICUS WITH CONTRALATERAL HEMIPLEGIA. Arch Ophthalmol. 1964 Mar;71:371–376. doi: 10.1001/archopht.1964.00970010387013. [DOI] [PubMed] [Google Scholar]
  2. ANASTASOPOULOS G., ROUTSONIS K., IERODIAKONOU C. S. Ophthalmic herpes zoster with contralateral hemiplegia. J Neurol Neurosurg Psychiatry. 1958 Aug;21(3):210–212. doi: 10.1136/jnnp.21.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bourdette D. N., Rosenberg N. L., Yatsu F. M. Herpes zoster ophthalmicus and delayed ipsilateral cerebral infarction. Neurology. 1983 Nov;33(11):1428–1432. doi: 10.1212/wnl.33.11.1428. [DOI] [PubMed] [Google Scholar]
  4. CRAVIOTO H., FEIGIN I. Noninfectious granulomatous angiitis with a predilection for the nervous system. Neurology. 1959 Sep;9:599–609. doi: 10.1212/wnl.9.9.599. [DOI] [PubMed] [Google Scholar]
  5. Doyle P. W., Gibson G., Dolman C. L. Herpes zoster ophthalmicus with contralateral hemiplegia: identification of cause. Ann Neurol. 1983 Jul;14(1):84–85. doi: 10.1002/ana.410140115. [DOI] [PubMed] [Google Scholar]
  6. Elble R. J. Intracerebral hemorrhage with herpes zoster ophthalmicus. Ann Neurol. 1983 Nov;14(5):591–592. doi: 10.1002/ana.410140518. [DOI] [PubMed] [Google Scholar]
  7. Esmann V., Ipsen J., Peterslund N. A., Seyer-Hansen K., Schønheyder H., Juhl H. Therapy of acute herpes zoster with acyclovir in the nonimmunocompromised host. Am J Med. 1982 Jul 20;73(1A):320–325. doi: 10.1016/0002-9343(82)90116-4. [DOI] [PubMed] [Google Scholar]
  8. Federico F., Pedone D., Lamberti P., Achille P., Camicia M., Carella A., Ferrari E. Ophthalmic herpes zoster with contralateral hemiparesis: a case report. J Neurol. 1982;228(4):283–287. doi: 10.1007/BF00313419. [DOI] [PubMed] [Google Scholar]
  9. Gardner-Thorpe C., Foster J. B., Barwick D. D. Unusual manifestations of herpes zoster. A clinical and electrophysiological study. J Neurol Sci. 1976 Aug;28(4):427–447. doi: 10.1016/0022-510x(76)90115-5. [DOI] [PubMed] [Google Scholar]
  10. Gilbert G. J. Herpes zoster ophthalmicus and delayed contralateral hemiparesis. Relationship of the syndrome to central nervous system granulomatous angiitis. JAMA. 1974 Jul 15;229(3):302–304. [PubMed] [Google Scholar]
  11. Gürsoy G., Aktin E., Bahar S., Tolun R., Ozden B. Post-herpetic aneurysm in the intrapetrosal portion of the internal carotid artery. Neuroradiology. 1980;19(5):279–282. doi: 10.1007/BF00347809. [DOI] [PubMed] [Google Scholar]
  12. Hilt D. C., Buchholz D., Krumholz A., Weiss H., Wolinsky J. S. Herpes zoster ophthalmicus and delayed contralateral hemiparesis caused by cerebral angiitis: diagnosis and management approaches. Ann Neurol. 1983 Nov;14(5):543–553. doi: 10.1002/ana.410140509. [DOI] [PubMed] [Google Scholar]
  13. Kolodny E. H., Rebeiz J. J., Caviness V. S., Jr, Richardson E. P., Jr Granulomatous angiitis of the central nervous system. Arch Neurol. 1968 Nov;19(5):510–524. doi: 10.1001/archneur.1968.00480050080008. [DOI] [PubMed] [Google Scholar]
  14. Kuroiwa Y., Furukawa T. Hemispheric infarction after herpes zoster ophthalmicus: computed tomography and angiography. Neurology. 1981 Aug;31(8):1030–1032. doi: 10.1212/wnl.31.8.1030. [DOI] [PubMed] [Google Scholar]
  15. LAWS H. W. Herpes zoster ophthalmicus complicated by contralateral hemiplegia. Arch Ophthalmol. 1960 Feb;63:273–280. doi: 10.1001/archopht.1960.00950020275010. [DOI] [PubMed] [Google Scholar]
  16. Landi G., Calloni M. V., Scarlato G. Transient contralateral hemiplegia after ophthalmic zoster. Therapeutic problems in elderly patients. J Neurol. 1981;224(4):297–300. doi: 10.1007/BF00313294. [DOI] [PubMed] [Google Scholar]
  17. Lightman S., Marsh R. J., Powell D. Herpes zoster ophthalmicus: a medical review. Br J Ophthalmol. 1981 Aug;65(8):539–541. doi: 10.1136/bjo.65.8.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Linnemann C. C., Jr, Alvira M. M. Pathogenesis of varicella-zoster angiitis in the CNS. Arch Neurol. 1980 Apr;37(4):239–240. doi: 10.1001/archneur.1980.00500530077013. [DOI] [PubMed] [Google Scholar]
  19. MINTON J. A case of left herpes zoster ophthalmicus followed by virus encephalitis with right-sided anaesthesia, paraesthesiae and hemiplegia. Trans Opthal Soc U K. 1956;76:227–233. [PubMed] [Google Scholar]
  20. MacKenzie R. A., Forbes G. S., Karnes W. E. Angiographic findings in herpes zoster arteritis. Ann Neurol. 1981 Nov;10(5):458–464. doi: 10.1002/ana.410100509. [DOI] [PubMed] [Google Scholar]
  21. Menkes D. B., Bishara S. N., Corbett A. J. Hemispheric infarction after herpes zoster ophthalmicus. J Neurol Neurosurg Psychiatry. 1983 Aug;46(8):786–787. doi: 10.1136/jnnp.46.8.786. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nishimaru K., Kamei H. [Case of herpes zoster ophthalmicus with contralateral hemiplegia]. Rinsho Shinkeigaku. 1976 Sep;16(9):649–653. [PubMed] [Google Scholar]
  23. Norris F. H., Jr, Leonards R., Calanchini P. R., Calder C. D. Herpes-zoster meningoencephalitis. J Infect Dis. 1970 Oct;122(4):335–338. doi: 10.1093/infdis/122.4.335. [DOI] [PubMed] [Google Scholar]
  24. Onoda M., Takahashi A. [Herpes zoster ophthalmicus followed by contralateral hemiparesis (author's transl)]. Rinsho Shinkeigaku. 1979 Aug;19(8):496–503. [PubMed] [Google Scholar]
  26. Pandi D. N., Romanes G. J. Ophthalmological herpes zoster complicated by hemiplegia. Br J Ophthalmol. 1966 Oct;50(10):610–611. doi: 10.1136/bjo.50.10.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Pratesi R., Freemon F. R., Lowry J. L. Herpes zoster ophthalmicus with contralateral hemiplegia. Arch Neurol. 1977 Oct;34(10):640–641. doi: 10.1001/archneur.1977.00500220074015. [DOI] [PubMed] [Google Scholar]
  28. Rehůrek J., Hanák L., Rehůrková M. Vzácná cerebrální komplikace u herpes zoster ophthalmicus. Cesk Oftalmol. 1974 Sep;30(5):370–374. [PubMed] [Google Scholar]
  29. Rosenblum W. I., Hadfield M. G. Granulomatous angiitis of the nervous system in cases of herpes zoster and lymphosarcoma. Neurology. 1972 Apr;22(4):348–354. doi: 10.1212/wnl.22.4.348. [DOI] [PubMed] [Google Scholar]
  30. Ruppenthal M. Changes of the central nervous system in herpes zoster. Acta Neuropathol. 1980;52(1):59–68. doi: 10.1007/BF00687229. [DOI] [PubMed] [Google Scholar]
  31. Selby P. J., Powles R. L., Janeson B., Kay H. E., Watson J. G., Thornton R., Morgenstern G., Clink H. M., McElwain T. J., Prentice H. G. Parenteral acyclovir therapy for herpesvirus infections in man. Lancet. 1979 Dec 15;2(8155):1267–1270. doi: 10.1016/s0140-6736(79)92281-5. [DOI] [PubMed] [Google Scholar]
  32. Sipe J. C., Rosenberg J. H. Granulomatous giant cell angiitis of the central nervous system. West J Med. 1977 Sep;127(3):215–220. [PMC free article] [PubMed] [Google Scholar]
  33. Walker R. J., 3rd, el-Gammal T., Allen M. B., Jr Cranial arteritis associated with herpes zoster. Case report with angiographic findings. Radiology. 1973 Apr;107(1):109–110. doi: 10.1148/107.1.109. [DOI] [PubMed] [Google Scholar]
  34. Whitley R. J., Soong S. J., Dolin R., Betts R., Linnemann C., Jr, Alford C. A., Jr Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients. N Engl J Med. 1982 Oct 14;307(16):971–975. doi: 10.1056/NEJM198210143071602. [DOI] [PubMed] [Google Scholar]
  35. Womack L. W., Liesegang T. J. Complications of herpes zoster ophthalmicus. Arch Ophthalmol. 1983 Jan;101(1):42–45. doi: 10.1001/archopht.1983.01040010044004. [DOI] [PubMed] [Google Scholar]
  36. von Schulthess G. K., Sauter C. Acyclovir and herpes zoster. N Engl J Med. 1981 Nov 26;305(22):1349–1349. doi: 10.1056/NEJM198111263052218. [DOI] [PubMed] [Google Scholar]

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