Retinal artery occlusion after herpes zoster mandibularis in a patient with systemic lupus erythematosus

摘要

While latent varicella zoster virus (VZV) infections are common, those limited to the facial nerve present as a rare form of VZV reactivation. Herpes zoster mandibularis is characterized as any involvement of the three branches of the trigeminal nerve manifesting as unilateral facial or oral pain. VZV-related vasculopathies can present as ischemic or hemorrhagic stroke, giant cell arteritis, cranial neuropathies, venous sinus thrombosis, spinal cord infarction, and peripheral artery thrombosis, all of which occur after the initial infection. Adults with herpes zoster reactivation exhibit a 31% increase in stroke frequency in the following year, with reactivations localizing to the ophthalmic area of the trigeminal nerve increasing stroke risk as high as 4.5-fold. Treatment of VZV vasculopathy may require prolonged intravenous acyclovir.