Orbital apex syndrome associated with herpes zoster ophthalmicus

Takuji Kurimoto1, Masahiro Tonari1, Norihiko Ishizaki1, Mitsuhiro Monta2, Saori Hirata2, Hidehiro Oku1, Jun Sugasawa1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, 2Department of Ophthalmology, Shitennoji Hospital, Osaka, JapanAbstract: We report our findings for a patient wi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kurimoto T, Tonari M, Ishizaki N, Monta M, Hirata S, Oku H, Sugasawa J, Ikeda T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/7b65251f66984510a5066d7e918cdb56
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7b65251f66984510a5066d7e918cdb56
record_format	dspace
spelling	oai:doaj.org-article:7b65251f66984510a5066d7e918cdb562021-12-02T02:59:15ZOrbital apex syndrome associated with herpes zoster ophthalmicus1177-54671177-5483https://doaj.org/article/7b65251f66984510a5066d7e918cdb562011-11-01T00:00:00Zhttp://www.dovepress.com/orbital-apex-syndrome-associated-with-herpes-zoster-ophthalmicus-a8632https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Takuji Kurimoto1, Masahiro Tonari1, Norihiko Ishizaki1, Mitsuhiro Monta2, Saori Hirata2, Hidehiro Oku1, Jun Sugasawa1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, 2Department of Ophthalmology, Shitennoji Hospital, Osaka, JapanAbstract: We report our findings for a patient with orbital apex syndrome associated with herpes zoster ophthalmicus. Our patient was initially admitted to a neighborhood hospital because of nausea and loss of appetite of 10 days&#39; duration. The day after hospitalization, she developed skin vesicles along the first division of the trigeminal nerve, with severe lid swelling and conjunctival injection. On suspicion of meningoencephalitis caused by varicella zoster virus, antiviral therapy with vidarabine and betamethasone was started. Seventeen days later, complete ptosis and ophthalmoplegia developed in the right eye. The light reflex in the right eye was absent and anisocoria was present, with the right pupil larger than the left. Fat-suppressed enhanced T1-weighted magnetic resonance images showed high intensity areas in the muscle cone, cavernous sinus, and orbital optic nerve sheath. Our patient was diagnosed with orbital apex syndrome, and because of skin vesicles in the first division of the trigeminal nerve, the orbital apex syndrome was considered to be caused by herpes zoster ophthalmicus. After the patient was transferred to our hospital, prednisolone 60 mg and vidarabine antiviral therapy was started, and fever and headaches disappeared five days later. The ophthalmoplegia and optic neuritis, but not the anisocoria, gradually resolved during tapering of oral therapy. From the clinical findings and course, the cause of the orbital apex syndrome was most likely invasion of the orbital apex and cavernous sinus by the herpes virus through the trigeminal nerve ganglia.Keywords: varicella zoster virus, orbital apex syndrome, herpes zoster ophthalmicus, complete ophthalmoplegiaKurimoto TTonari MIshizaki NMonta MHirata SOku HSugasawa JIkeda TDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2011, Iss default, Pp 1603-1608 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kurimoto T Tonari M Ishizaki N Monta M Hirata S Oku H Sugasawa J Ikeda T Orbital apex syndrome associated with herpes zoster ophthalmicus
description	Takuji Kurimoto1, Masahiro Tonari1, Norihiko Ishizaki1, Mitsuhiro Monta2, Saori Hirata2, Hidehiro Oku1, Jun Sugasawa1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, 2Department of Ophthalmology, Shitennoji Hospital, Osaka, JapanAbstract: We report our findings for a patient with orbital apex syndrome associated with herpes zoster ophthalmicus. Our patient was initially admitted to a neighborhood hospital because of nausea and loss of appetite of 10 days&#39; duration. The day after hospitalization, she developed skin vesicles along the first division of the trigeminal nerve, with severe lid swelling and conjunctival injection. On suspicion of meningoencephalitis caused by varicella zoster virus, antiviral therapy with vidarabine and betamethasone was started. Seventeen days later, complete ptosis and ophthalmoplegia developed in the right eye. The light reflex in the right eye was absent and anisocoria was present, with the right pupil larger than the left. Fat-suppressed enhanced T1-weighted magnetic resonance images showed high intensity areas in the muscle cone, cavernous sinus, and orbital optic nerve sheath. Our patient was diagnosed with orbital apex syndrome, and because of skin vesicles in the first division of the trigeminal nerve, the orbital apex syndrome was considered to be caused by herpes zoster ophthalmicus. After the patient was transferred to our hospital, prednisolone 60 mg and vidarabine antiviral therapy was started, and fever and headaches disappeared five days later. The ophthalmoplegia and optic neuritis, but not the anisocoria, gradually resolved during tapering of oral therapy. From the clinical findings and course, the cause of the orbital apex syndrome was most likely invasion of the orbital apex and cavernous sinus by the herpes virus through the trigeminal nerve ganglia.Keywords: varicella zoster virus, orbital apex syndrome, herpes zoster ophthalmicus, complete ophthalmoplegia
format	article
author	Kurimoto T Tonari M Ishizaki N Monta M Hirata S Oku H Sugasawa J Ikeda T
author_facet	Kurimoto T Tonari M Ishizaki N Monta M Hirata S Oku H Sugasawa J Ikeda T
author_sort	Kurimoto T
title	Orbital apex syndrome associated with herpes zoster ophthalmicus
title_short	Orbital apex syndrome associated with herpes zoster ophthalmicus
title_full	Orbital apex syndrome associated with herpes zoster ophthalmicus
title_fullStr	Orbital apex syndrome associated with herpes zoster ophthalmicus
title_full_unstemmed	Orbital apex syndrome associated with herpes zoster ophthalmicus
title_sort	orbital apex syndrome associated with herpes zoster ophthalmicus
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/7b65251f66984510a5066d7e918cdb56
work_keys_str_mv	AT kurimotot orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT tonarim orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT ishizakin orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT montam orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT hiratas orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT okuh orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT sugasawaj orbitalapexsyndromeassociatedwithherpeszosterophthalmicus AT ikedat orbitalapexsyndromeassociatedwithherpeszosterophthalmicus
_version_	1718401991240056832

Orbital apex syndrome associated with herpes zoster ophthalmicus

Ejemplares similares