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March 1979

Herpes Zoster Ophthalmicus

Author Affiliations

Div Neurol Dept Medicine Dartmouth Med School Hanover, NH 03755

Arch Neurol. 1979;36(3):179. doi:10.1001/archneur.1979.00500390097015

To the Editor.—  The article by Pratesi et al in the Archives (34:640-641, 1977) illustrates well the intracranial arteritis that may complicate herpes zoster ophthalmicus (HZO). We take issue with the authors' statement that "the clinical picture of a hemispheric stroke a few weeks following HZO is well enough established that angiography can be avoided in the future." The following report illustrates that all cases of hemiplegia occurring after HZO may not be secondary to herpes vasculitis and that angiography still plays an important role in the differentiation of these various conditions.

Report of a Case.—  A 74-year-old woman had HZO develop in the right eye, which was responsive in part to a short course of steroids. Two to three weeks later she became lethargic, complained of diffuse headache, and a short time later left-sided weakness developed. Examination revealed a lethargic, disoriented woman whose eyes were tonically deviated to the right.