• Yoshifumi Ashikawa, Fumiko Kusunoki Nakamoto, Tatsuya Sato, Junko Katsumata, Taro Bannai, Tomonari Seki, Masako Takeda, and Yasushi Shiio.
• Department of Neurology, Tokyo Teishin Hospital, Japan.
• Intern. Med. 2023 Feb 15; 62 (4): 623627623-627.

AbstractA 56-year-old man presented with right-sided headache and ptosis accompanied by a facial skin rash. He was diagnosed with herpes zoster ophthalmicus (HZO). Despite acyclovir and steroid therapy, the ocular symptoms worsened. Magnetic resonance imaging (MRI) revealed severe orbital inflammation and abnormal lesions in the right trigeminal nucleus and tract. The effects of re-administration of intravenous acyclovir and steroid pulse therapy were limited. Laser irradiation of the stellate ganglion (SGL) and high-dose oral prednisolone therapy were effective. Our experience suggests the efficacy of early multimodal treatment, including SGL, in treating ocular symptoms associated with HZO.

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