Herpes zoster ophthalmicus mimicking carotid artery dissection: a case report

Herpes zoster is a common viral illness presenting with vesicular eruptions which are usually preceded by pain, erythema, and tenderness in a dermatomal distribution. The ophthalmic division of the trigeminal nerve is commonly involved (herpes zoster ophthalmicus). Early diagnosis before eruption of vesicles can be difficult and symptoms may be confused with other neurologic disorders. We present a patient with herpes zoster ophthalmicus who presented with face and neck pain associated with visual symptoms mimicking carotid artery dissection. Atypical presentation and benefits of early antiviral treatment are discussed.