Trigeminal herpes zoster and Ramsay Hunt syndrome with a lesion in the spinal trigeminal nucleus and tract.
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 T(2)-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.
Chia-Wei
CW
Hung
Shuu-Jiun
SJ
Wang
Shih-Pin
SP
Chen
Jiing-Feng
JF
Lirng
Jong-Ling
JL
Fuh
D000368:Aged; D001921:Brain / Q000473:pathology; D005154:Facial Nerve / Q000473:pathology; D006562:Herpes Zoster / Q000150:complications / Q000473:pathology*; D016697:Herpes Zoster Oticus / Q000150:complications / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D020433:Trigeminal Nerve Diseases / Q000150:complications / Q000473:pathology*; D014279:Trigeminal Nucleus, Spinal / Q000473:pathology*