Trigeminal nerve imaging abnormalities in a child with herpes zoster ophthalmicus

Reactivation of latent varicella zoster virus in the trigeminal ganglion with involvement of the ophthalmic division of the trigeminal nerve causes herpes zoster ophthalmicus. This is rare in children and imaging is seldom performed since the diagnosis is primarily clinical. As a result, descriptions of the associated imaging abnormalities are sparse, particularly in the paediatric literature. We present the case of a previously healthy child with herpes zoster ophthalmicus who underwent a magnetic resonance imaging scan that demonstrated enlargement and enhancement of the ipsilateral trigeminal nerve and its branches. Our aim is to highlight this finding as a potential imaging feature of herpes zoster ophthalmicus, which, to our knowledge, has not previously been reported in children.