Zoster related multiple cranial nerve palsies: an unusual complication following percutaneous balloon compression for trigeminal neuralgia

A patient demonstrating multiple cranial nerve palsies involving the IXth, Xth, XIth and XIIth cranial nerves following percutaneous balloon compression of the trigeminal ganglion for post-herpetic trigeminal neuralgia is presented. This collection of lower cranial nerve palsies, including the accessory nerve, has not been previously described as a complication of this procedure. This unusual group of cranial nerve palsies resulted from reactivation of the varicella-zoster virus (VZV) secondary to the procedure.