CONTRALATERAL HEMIPLEGIA COMPLICATING HERPES-ZOSTER OPHTHALMICUS

Contralateral hemiplegia complicating herpes zoster ophthalmicus (HZO) was first recognized by Dumary in 1896 and subsequent reports have confirmed this association. Although the clinical syndrome is well defined, the pathogenesis is less clear. Angiographic studies in this syndrome have revealed carotid siphon abnormalities in some cases and segmental constriction of major intracerebral vessels in others 1-3. Indeed at one point it was suggested that large vessel arteritis was so well established as the pathological process in this unusual syndrome that arteriography was an unnecessary investigation 4. In this paper we report the case of a patient with HZO complicated by contralateral hemiplegia in whom carotid angiography was normal. It is probable that small vessel arteritis underlies a number of cases of contralateral hemiplegia seen in association with HZO.