Trigeminal herpes zoster complicated by Ramsay Hunt syndrome

We report the case of a 55-year-old woman with herpes zoster of the mandibular branch of the left trigeminal nerve, which was complicated within 4 days by ipsilateral Ramsay Hunt syndrome. Recently, a case of trigeminal herpes zoster and Ramsay Hunt syndrome was described, in which the MRI and CSF findings along with the clinical course urged the authors to suggest the possibility of transaxonal spread of the virus. In our case, the findings and particularly the temporal relation between the 2 conditions render more plausible other pathophysiological mechanisms, such as the spread of the virus through the CSF.