Lateral Rectus Palsy Caused by Herpes Zoster Ophthalmicus

Öz

Kazanılmış abducens siniri felci horizontal diplopi ile kendini gösterir. Herpes simplex oftalmicus kazanılmış abducens siniri felcinin nadir görülen ama önemli sebeplerinden biridir; kendi kendini sınırlayan ve geçici özellikte olmasıyla diğer sebeplerden ayrılabilir. 65 yaşında kadın hasta, yeni ortaya çıkan çift görme ve baş ağrısı şikayeti ile polikliniğe başvurmuştur. Muayenesinde sol göz çevresinde veziküler döküntü ve dışa bakış kısıtlılığı mevcuttur. Valasiklovir ile tedavi edilmiştir. Bu tip olgularda cilt lezyonu özellikle veziküler döküntü sorgulanmalıdır. Ancak Herpes simplex’e bağlı abducens felcinin döküntünün kaybolmasından çok daha sonra da ortaya çıkabileceği unutulmamalıdır.

Anahtar Kelimeler

• Herpes Virüs,Herpes Zoster,Altıncı Sinir Felci,Diplopi,Dış Rectus Felci

Lateral Rectus Palsy Caused by Herpes Zoster Ophthalmicus

Öz

Acquired abducens nerve palsy presents with horizontal diplopia which has a vary of differential diagnosis. Lateral rectus palsy caused by herpes simplex ophtalmicus (HZO) is a transient and self-limiting condition. A 65 year-old woman prensents with double vision and headache. On examination vesicular lesions in left eye with abduction limitation are observed and treated by valacyclovir. In isolated abducens nerve palsy, skin lesions especially vesicular rash should be questioned. One should keep in mind that acquired horizontal diplopia may present following HZO.

Anahtar Kelimeler

• Herpes Virus,Herpes Zoster,Sixth Nerve Palsy,Diplopia,Lateral Rectus Palsy

Kaynakça

1. 1. Rucker CW. The causes of paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol. 1966;61: 1293–1298.
2. 2. Lee MS, Galetta SL, Volpe NJ, Liu GT: Sixth nerve palsies in children. Pediatr Neurol. 1999;20: 49–52.
3. 3. Edgerton AE: Herpes zoster ophthalmicus: report of cases and a review of the literature. Trans Am Ophthalmol Soc. 1942;40: 390–439.
4. 4. Aksoy S, Akova YA: Clinical diagnosis and treatment in herpetic anterior uveitis. Turk J Ophthalmol. 2009;39: 485-490.
5. 5. Shin MK, Choi CP, Lee MY. A case of herpes zoster with abducens palsy. J Korean Med Sci. 2007;22: 905–907.
6. 6. Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, Betts RF, Gershon AA, Haanpaa ML, McKendrick MW, Nurmikko TJ,Oaklander AL, Oxman MN, Pavan-Langston D, Petersen KL, Rowbotham MC, Schmader KE, Stacey BR, Tyring SK, van Wijck AJ, Wallace MS, Wassilew SW, Whitley RJ. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007;44: 1.
7. 7. Zaal MJ, Völker-Dieben HJ, D'Amaro J. Prognostic value of Hutchinson's sign in acute herpes zoster ophthalmicus. Graefes Arch Clin Exp Ophthalmol. 2003;241: 187.
8. 8. Pavan-Langston D. Herpes zoster ophthalmicus. Neurology 1995;45: 50.

9. 9. Kost RG, Straus SE. Postherpetic neuralgia--pathogenesis, treatment, and prevention. N Engl J Med. 1996;335: 32.
10. 10. Elrod RD, Weinberg DA. Ocular myasthenia gravis. Ophthalmol Clin North Am. 2004;17: 275.
11. 11. Slavin ML, Glaser JS. Idiopathic orbital myositis: report of six cases. Arch Ophthalmol. 1982;100: 1261.
12. 12. Shin HM, Lew H, Yun YS. A case of complete ophthalmoplegia in herpes zoster ophthalmicus. Korean J Ophthalmol. 2005;19: 302–304.