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KMID : 1036520110010010085
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Clinical Neuro-Ophthalmology
2011 Volume.1 No. 1 p.85 ~ p.86
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A Case of Complete Ophthalmoplegia in Herpes Zoster Ophthalmicus
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Park Ji-Yun
Kim Tae-Eun
Lee Tae-Kyeong
Sung Ki-Bum
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Abstract
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As a complication of herpes zoster ophthalmicus (HZO), the complete ophthalmoplegia due to involvement of all ocular motor nerves are rare and it usually takes the form of individual ocular palsy. We report a case of 77-year-old woman who developed complete unilateral internal and external ophthalmoplegia during convalescent period of HZO. The ophthalmoplegia developed from 16 days after onset of HZO when the conjunctivitis and keratitis had been recovered. Examination revealed fixed dilated pupil with complete ptosis. Ocular movements are impaired in all directions with no resistance in forced duction test. Orbital magnetic resonance imaging showed no abnormal findings. Oral prednisolone was administered and the ophthalmoplegia gradually improved completely by 2 months. The cause of HZO-related ophthalmoplegia has been postulated to be due to myositis, vasculitis and perineuritis. The response of oral steroids and the time of onset support the immune-mediated inflammation of ocular motor nerves as a pathophysiology in this case.
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KEYWORD
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Herpes zoster ophthalmicus, Ophthalmoplegia, Blepharoptosis
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