Trigeminal herpes zoster and Ramsay Hunt Syndrome with a lesion in the spinal trigeminal nucleus and tract |
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| Authors: | Chia-Wei Hung Shuu-Jiun Wang Shih-Pin Chen Jiing-Feng Lirng Jong-Ling Fuh |
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| Institution: | (1) Department of Neurology, Yangming Branch, Taipei City Hospital, Taipei, Taiwan, ROC;(2) National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC;(3) Neurological Institute, Taipei Veterans General Hospital, 112 Taipei, Taiwan, ROC;(4) Radiology Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC;(5) Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; |
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| 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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