Abstract
We report the case of a 77-year-old immuno-competent man who developed herpes zoster in the maxillary and mandibular branches of the trigeminal nerve. Within 3 weeks, he developed ipsilateral peripheral facial palsy, hearing loss, vesicles over the external auditory canal, and pain in the face and ear. A T2-weighted MRI of the brain revealed a hyper-intense lesion at the right medulla corresponding to the spinal trigeminal nucleus and tract. Gadolinium enhancement was seen over the right facial nerve. These lesions suggest a possibility of transaxonal spread of the varicella zoster virus between the trigeminal nerve, the facial nerve, and the spinal trigeminal nucleus and tract.
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This study was supported in part by grants from the Taipei Veterans General Hospital (V99C1-047).
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Hung, CW., Wang, SJ., Chen, SP. et al. Trigeminal herpes zoster and Ramsay Hunt Syndrome with a lesion in the spinal trigeminal nucleus and tract. J Neurol 257, 1045–1046 (2010). https://doi.org/10.1007/s00415-010-5487-6
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DOI: https://doi.org/10.1007/s00415-010-5487-6