[Case of Horner's syndrome associated with ophthalmic herpes zoster]

We reported a 74-year-old man with right Horner's syndrome associated with ophthalmic herpes zoster. He presented acute onset of pain, swelling, vesicular cutaneous eruption around the right eyelid. A diagnosis of herpes zoster ophthalmicus was made and he was started on acyclovir 750 mg/day. Seven days later he manifested right abduction deficit On admission nine days later, the right eyelid became ptotic and the right pupil was smaller than the left There was gradual improvement over the next 10 days in ptosis and miosis, and over the next 3 weeks in the right abduction deficit. As the sympathetic nerve runs with the carotid artery, it partially joins the sixth nerve within the cavernous sinus. We have identified a patient in whom herpes zoster ophthalmicus has resulted in a syndrome involving the sympathetic nerves, the sixth nerve, and the first division of the fifth cranial nerve. As the Horner's syndrome was transient, we might miss the symptom in the early stage, so we should carefully examine the patients.