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Updated: Feb 2, 2026

Plaquing of Herpes Simplex Viruses
Published on: November 5, 2021
Trigeminal herpes zoster and Ramsay Hunt syndrome in an elderly adult: Presentation with prodromal toothache
John K Brooks1, Arash M Rostami2, Douglas C McCorkle3
1Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA.
Objective:
This article describes an atypical herpes zoster (HZ) infection heralded by prodromic dental pain.
Background:
Trigeminal HZ is associated with any of the three divisions of the trigeminal nerve, and Ramsay Hunt syndrome is a rare variant of HZ infection of the ear, often accompanied with unilateral facial nerve palsy.
Materials And Methods:
An 87-year-old man sought remedy for tooth-like pain. Within a week, he developed cutaneous, intraoral and otic eruptions, hearing loss, and mild facial palsy.
Results:
After ruling out odontogenic pain, he was diagnosed with trigeminal HZ and Ramsay Hunt syndrome.
Conclusion:
Herpes zoster infection should be included as a possible aetiologic factor with atypical presentations of odontogenic pain. Diagnosis of trigeminal HZ infection and the Ramsay Hunt syndrome may lead to timely intervention with antivirals and improved patient outcomes.
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