Hyponatremia: It’s in the Eye of the Beholder: Pitfalls in the Diagnosis and Treatment of SIADH with Desalination due to Herpes Zoster Ophthalmicus (HZO)

Herpes Zoster Ophthalmicus (HZO) is a rare cause of SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone secretion). It occurs when herpesvirus type 3 activation presents in the first division, or ophthalmic division of the trigeminal nerve.

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Herpes zoster ophthalmicus at a tertiary health facility, South-western Nigeria: Clinical presentations and outcome

Annals of Health Research ◽

10.30442/ahr.0603-10-96 ◽

2020 ◽

Vol 6 (3) ◽

pp. 333-337

Author(s):

O Fasina ◽

SJ Hughes

Keyword(s):

Herpes Zoster ◽

Health Facility ◽

Trigeminal Nerve ◽

Significant Proportion ◽

Herpes Zoster Ophthalmicus ◽

Varicella Zoster ◽

Clinical Presentations ◽

Immunodeficiency Virus ◽

Antiviral Medications ◽

Type 3

Herpes zoster ophthalmicus is a neurocutaneous disease caused by the human alpha herpes virus Type 3 and it is characterized by reactivation of dormant varicella-zoster virus lying within the trigeminal ganglia. The objective of this study was to describe the clinical presentation and management outcome of patients with herpes zoster ophthalmicus in a tertiary health facility. This was a retrospective study of patients with herpes zoster ophthalmicus managed at the Eye Clinic of a tertiary health facility in the South-western part of Nigeria over eight years. There were 17 patients, comprising five males and the mean age at presentation was 54.9±13.7 years. Seven (41.2%) patients were seropositive for the Human Immunodeficiency Virus (HIV) while nine (52.9%) patients had corneal involvement. Fifteen (88.2%) patients had involvement of the first branch of the trigeminal nerve (V1), and one (5.9%) patient each had involvement of the second branch of the trigeminal nerve (V2) and the first two branches of the trigeminal nerve (V1 and V2). All the patients were managed with oral and topical antiviral medications. Ten patients (58.8%) developed postherpetic neuralgia. In conclusion, Herpes zoster ophthalmicus is strongly associated with HIV seropositivity and older age and a significant proportion of patients develop post-herpetic neuralgia necessitating long term management.

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A Pediatric Case of Relapsing-Remitting Multiple Sclerosis Onset following Varicella Zoster Ophthalmicus with Optic Neuritis

Case Reports in Pediatrics ◽

10.1155/2018/6931206 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Naoko Shiba ◽

Yuji Inaba ◽

Mitsuo Motobayashi ◽

Makoto Nishioka ◽

Yoichiro Kawasaki ◽

...

Keyword(s):

Multiple Sclerosis ◽

Herpes Zoster ◽

Optic Neuritis ◽

Trigeminal Nerve ◽

Present Report ◽

Epidemiological Studies ◽

Herpes Zoster Ophthalmicus ◽

Varicella Zoster ◽

Relapsing Remitting ◽

Relapsing Remitting Multiple Sclerosis

Some epidemiological studies have implied a pathogenetic association between varicella zoster virus (VZV) and multiple sclerosis (MS); this, however, remains controversial. The present report describes a case involving an immunocompetent 10-year-old girl who developed relapsing-remitting MS following the prolonged reactivation of VZV inside the first branch of the trigeminal nerve, exhibiting herpes zoster ophthalmicus with severe optic neuritis. Symptoms related to herpes zoster ophthalmicus and MS appeared consecutively in the 10-week period after the appearance of vesicles. This suggests that the onset of MS was triggered by some mechanism involving VZV reactivation in the first branch of the trigeminal nerve. To the best of our knowledge, this report is the first to describe a relationship between the onset of MS and herpes zoster ophthalmicus. Early diagnosis and aggressive antiviral therapy are important in cases of herpes zoster ophthalmicus to prevent the possible development of MS as well as visual impairment as sequela.

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