Abducens Nerve Palsy as a Complication of Herpes Zoster Ophthalmicus: A Case Report

Al-sadi, Anas; Abdulgayoom, Mohammed; Jawarneh, Israa; Al-warqi, Akram

doi:10.7759/cureus.22920

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…The prognosis of ophthalmoplegia is generally favorable. It was reported that the duration of diplopia associated with ocular motor palsy was between 2 and 23 months [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Isolated Abducens Nerve Palsy After Herpes Zoster Ophthalmicus: A Case Report

2023

rjo

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Aim: The purpose of this study was to demonstrate a case of herpes zoster in the patient. Methods: Case report. Results: Herpes zoster ophthalmicus is a rare but well-known cause of CN VI palsy that affects an elderly patient due to a reduction in the immunity to the Varicella Zoster Virus (VZV). We reported a case of herpes zoster in our patient, a 67-year-old Javanese female who presented with a VI nerve palsy within 1 week after the vesicular rash. Our patient received Valacyclovir, Gabapentin, and steroid treatment, then responded quite well to the combination of these therapies without side effects as the goals were to diminish acute and chronic pain, fasten the healing of the skin and nerve, and reduce the chances of dissemination. Based on studies, systemic antivirals should be given in all cases of HZO to minimize complications and steroids should not be given without antiviral therapy so as not to increase viral replication. Conclusions: As a complication of HZO, ophthalmoplegia may have various origins. We reported a case of sixth nerve palsy in HZO. Abbreviations: HZO = herpes zoster ophthalmicus, VZV = varicella-zoster virus, CN = Cranial Nerve

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“…The prognosis of ophthalmoplegia is generally favorable. It was reported that the duration of diplopia associated with ocular motor palsy was between 2 and 23 months [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Isolated Abducens Nerve Palsy After Herpes Zoster Ophthalmicus: A Case Report

2023

rjo

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“…In the case of herpes zoster or shingles, it is important to note that this viral infection can lead to secondary bacterial infections. Herpes zoster is caused by the reactivation of the varicella-zoster virus (VZV) after a period of latency following primary infection with varicella (chickenpox) [ 13 ]. The reactivated virus travels from the dorsal root ganglion down the sensory nerves to the skin, causing a characteristic rash and associated symptoms [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Spinal cord stimulator explant caused by post-incisional cellulitis secondary to Varicella Zoster Virus (shingles) infection: a case report

Mohabbati,

Papan

2023

J Med Case Reports

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Introduction Spinal Cord Stimulation (SCS) is a well-established therapy for refractory neuropathic pain, known for its safety and minimally-invasive nature. However, complications, including surgical site infections (SSIs), can arise post-implantation. SCS-related SSIs occur in 3.4% to 4.6% of cases within 90 days post-implant, often requiring device removal and impacting pain management and healthcare costs. The impulse generator, electrode implant site and lumbar/thoracic surgical site are commonly affected, with local skin flora and circulating organisms being the primary causes of infection. Case presentation An 80-year-old Lebanese male with chronic neuropathic lower back and bilateral leg pain, significantly impairing function, underwent prolonged hospitalizations for COVID-19 infection and acute-on-chronic pain with Urinary Tract Infection (UTI). Considering SCS as a therapeutic option, a successful trial led to permanent implantation, resulting in improved pain severity and functional capacity. However, three months later, the patient developed post-incisional cellulitis and wound dehiscence secondary to Varicella Zoster Virus (shingles) Infection directly over the Implantable Pulse Generator (IPG) incision line. Despite antibiotic treatment, the infection progressed, necessitating SCS system explantation. Discussion This represents the first reported case of VZV infection causing wound dehiscence and SCS explantation post-implantation. Contributing factors may include itching around the IPG site, facilitating deeper tissue inoculation. Laboratory and imaging tests may not reliably detect SSIs, and superficial infections may respond to antibiotics, while deep infections typically require implant removal. Early identification and intervention are vital to minimize complications. Conclusion This unique case emphasizes the need for heightened vigilance and monitoring in patients with viral infections near medical devices. A standardized approach to assessing and managing SCS-related infections is critical. Sharing such experiences contributes to improved understanding and treatment of these rare incidents.

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Abducens Nerve Palsy as a Complication of Herpes Zoster Ophthalmicus: A Case Report

Cited by 2 publications

References 14 publications

Isolated Abducens Nerve Palsy After Herpes Zoster Ophthalmicus: A Case Report

Isolated Abducens Nerve Palsy After Herpes Zoster Ophthalmicus: A Case Report

Spinal cord stimulator explant caused by post-incisional cellulitis secondary to Varicella Zoster Virus (shingles) infection: a case report

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