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Trigeminal herpes zoster and Ramsay Hunt Syndrome with a lesion in the spinal trigeminal nucleus and tract

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Abstract

We report the case of a 77-year-old immuno-competent man who developed herpes zoster in the maxillary and mandibular branches of the trigeminal nerve. Within 3 weeks, he developed ipsilateral peripheral facial palsy, hearing loss, vesicles over the external auditory canal, and pain in the face and ear. A T2-weighted MRI of the brain revealed a hyper-intense lesion at the right medulla corresponding to the spinal trigeminal nucleus and tract. Gadolinium enhancement was seen over the right facial nerve. These lesions suggest a possibility of transaxonal spread of the varicella zoster virus between the trigeminal nerve, the facial nerve, and the spinal trigeminal nucleus and tract.

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Acknowledgments

This study was supported in part by grants from the Taipei Veterans General Hospital (V99C1-047).

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Authors and Affiliations

  1. Department of Neurology, Yangming Branch, Taipei City Hospital, Taipei, Taiwan, ROC

    Chia-Wei Hung

  2. National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC

    Chia-Wei Hung, Shuu-Jiun Wang, Shih-Pin Chen, Jiing-Feng Lirng & Jong-Ling Fuh

  3. Neurological Institute, Taipei Veterans General Hospital, 112, Taipei, Taiwan, ROC

    Shuu-Jiun Wang, Shih-Pin Chen & Jong-Ling Fuh

  4. Radiology Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC

    Jiing-Feng Lirng

  5. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

    Chia-Wei Hung & Shih-Pin Chen

Authors
  1. Chia-Wei Hung
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  2. Shuu-Jiun Wang
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  3. Shih-Pin Chen
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  4. Jiing-Feng Lirng
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  5. Jong-Ling Fuh
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Correspondence to Jong-Ling Fuh.

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Hung, CW., Wang, SJ., Chen, SP. et al. Trigeminal herpes zoster and Ramsay Hunt Syndrome with a lesion in the spinal trigeminal nucleus and tract. J Neurol 257, 1045–1046 (2010). https://doi.org/10.1007/s00415-010-5487-6

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  • DOI: https://doi.org/10.1007/s00415-010-5487-6

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