Isolated Abducens Nerve Palsy After Herpes Zoster Ophthalmicus: A Case Report

Rom J Ophthalmol. 2023 Oct-Dec;67(4):408-411. doi: 10.22336/rjo.2023.65.

Abstract

Aim: The purpose of this study was to demonstrate a case of herpes zoster in the patient. Methods: Case report. Results: Herpes zoster ophthalmicus is a rare but well-known cause of CN VI palsy that affects an elderly patient due to a reduction in the immunity to the Varicella Zoster Virus (VZV). We reported a case of herpes zoster in our patient, a 67-year-old Javanese female who presented with a VI nerve palsy within 1 week after the vesicular rash. Our patient received Valacyclovir, Gabapentin, and steroid treatment, then responded quite well to the combination of these therapies without side effects as the goals were to diminish acute and chronic pain, fasten the healing of the skin and nerve, and reduce the chances of dissemination. Based on studies, systemic antivirals should be given in all cases of HZO to minimize complications and steroids should not be given without antiviral therapy so as not to increase viral replication. Conclusions: As a complication of HZO, ophthalmoplegia may have various origins. We reported a case of sixth nerve palsy in HZO. Abbreviations: HZO = herpes zoster ophthalmicus, VZV = varicella-zoster virus, CN = Cranial Nerve.

Keywords: cranial nerve VI palsy; herpes zoster ophthalmicus; varicella-zoster virus.

Publication types

  • Case Reports

MeSH terms

  • Abducens Nerve Diseases* / diagnosis
  • Abducens Nerve Diseases* / drug therapy
  • Abducens Nerve Diseases* / etiology
  • Aged
  • Antiviral Agents / therapeutic use
  • Female
  • Herpes Zoster Ophthalmicus* / complications
  • Herpes Zoster Ophthalmicus* / diagnosis
  • Herpes Zoster Ophthalmicus* / drug therapy
  • Herpesvirus 3, Human / physiology
  • Humans

Substances

  • Antiviral Agents