Occipital neuralgia evoked by facial herpes zoster infection.
Occipital neuralgia is a pain syndrome which may usually be induced by spasms of the cervical muscles or trauma to the greater or lesser occipital nerves. We report a patient with occipital neuralgia followed by facial herpes lesion. A 74-year-old male experienced sudden-onset severe headache in the occipital area. The pain was localized to the distribution of the right side of the greater occipital nerve, and palpation of the right greater occipital nerve reproduces the pain. He was diagnosed with occipital neuralgia according to ICHD-II criteria. A few days later, the occipital pain was followed by reddening of the skin and the appearance, of varying size, of vesicles on the right side of his face (the maxillary nerve and the mandibular nerve region). This was diagnosed as herpes zoster. This case represents a combination of facial herpes lesions and pain in the C2 and C3 regions. The pain syndromes can be confusing, and the classic herpes zoster infection should be considered even when no skin lesions are established.
Kihara
Takeshi
T
Department of Neuroscience for Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida-Shimoadachi-cho 46-29, Sakyo-ku, Kyoto 606-8501, Japan.
Shimohama
Shun
S
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D005156:Facial Neuralgia / Q000150:complications; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009437:Neuralgia / Q000209:etiology*; D013035:Spasm / Q000150:complications; D014277:Trigeminal Neuralgia / Q000150:complications
D000998:Antiviral Agents