[Delayed contralateral hemiplegia complicating ophthalmic herpes zoster]

Area of Science:

• Neurology
• Infectious Diseases
• Vascular Neurology

Background:

• Ophthalmic herpes zoster, a viral infection affecting the eye and surrounding area, can have delayed neurological complications.
• Understanding the link between herpes zoster and subsequent neurological deficits is crucial for timely diagnosis and management.

Observation:

• Contralateral hemiplegia, a form of paralysis, may manifest several weeks post-herpes zoster onset.
• This complication is distinct from direct herpetic encephalopathy.

Findings:

• The hemiplegia is associated with arteritis, inflammation of blood vessels, affecting the middle and anterior cerebral arteries.
• Arteriography reveals lesions primarily in the proximal segments of these cerebral arteries, leading to ischemic infarcts.

Implications:

• The pathophysiology suggests vascular invasion by contiguity from the initial herpes zoster infection.
• Early recognition of this pattern is vital for preventing severe neurological damage and improving patient outcomes.