Right-sided Herpes Zoster Ophthalmicus Complicated by Bilateral Third, Fourth, and Sixth Cranial Nerve Palsies and Syndrome of Inappropriate Antidiuretic Hormone Secretion: A Case Report

Tomoaki Shima; Kairi Yamashita; Kanako Furuta; Kohei Tsujino; Saeko Nagai; Daiji Torimura; Hiroaki Ohtsuka; Yuki Tomita; Takuro Hirayama; Shunsuke Yoshimura; Teiichiro Miyazaki; Yohei Tateishi; Akira Tsujino

doi:10.2169/internalmedicine.2878-23

Tomoaki Shima, Kairi Yamashita, Kanako Furuta, Kohei Tsujino, Saeko Nagai, Daiji Torimura, Hiroaki Ohtsuka, Yuki Tomita, Takuro Hirayama, Shunsuke Yoshimura, Teiichiro Miyazaki, Yohei Tateishi, Akira Tsujino

Author information

Tomoaki Shima
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Kairi Yamashita
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Kanako Furuta
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Kohei Tsujino
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Saeko Nagai
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Daiji Torimura
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Hiroaki Ohtsuka
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Yuki Tomita
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Takuro Hirayama
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Shunsuke Yoshimura
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Teiichiro Miyazaki
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Yohei Tateishi
Department of Neurology and Strokology, Nagasaki University Hospital, Japan
Akira Tsujino
Department of Neurology and Strokology, Nagasaki University Hospital, Japan

Keywords: herpes zoster ophthalmicus, ophthalmoplegia, cranial nerve palsy, syndrome of inappropriate antidiuretic hormone secretion

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2878-23

DOI https://doi.org/10.2169/internalmedicine.2878-23

Details

Abstract

Cases of herpes zoster ophthalmicus (HZO) complicated by bilateral ophthalmoplegia are rare, and no cases of bilateral third, fourth, or sixth cranial nerve palsies have been reported. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare complication of HZO. We herein report an 80-year-old Japanese woman with right-sided HZO complicated by meningoencephalitis and discuss the pathogenesis of this condition. She developed bilateral third, fourth, and sixth cranial nerve palsies and SIADH almost simultaneously during treatment for HZO. The bilateral cranial palsy spontaneously resolved within a few months.

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