• Internal medicine · Jun 2024

    Delayed Superior Orbital Fissure Syndrome Arising More than One Month after Herpes Zoster Ophthalmicus and Meningitis.

    • Sunao Takahashi, Kotaro Okabayashi, Itsuki Soejima, Ayako Oniki, Shoichiro Ishihara, and Hiroyuki Tomimitsu.
    • Department of Neurology, JA Toride Medical Center, Japan.
    • Intern. Med. 2024 Jun 6.

    AbstractA 79-year-old woman developed herpes zoster ophthalmicus (HZO) with a vesicular rash on the nasal root, which developed soon after intravenous acyclovir therapy. Although varicella zoster virus DNA was undetectable in the cerebrospinal fluid, she presented with ophthalmoplegia without optic nerve dysfunction 32 days after the onset of HZO. We diagnosed the patient with superior orbital fissure syndrome and administered intravenous immunoglobulin and systemic corticosteroids. Ophthalmoplegia did not immediately respond to these therapies but resolved 4 months later. We should be aware that ophthalmoplegia can occur, even after HZO and meningitis are completely treated.

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