Bilateral abducens nerve palsy in herpes zoster: A case report

Herpes zoster (shingles) is a viral infection that is caused by the reactivation of varicella-zoster virus (VZV), which remains dormant in the sensory ganglia after the preliminary infection. We document a case of ocular motor paralysis due to herpes zoster. A 17-year-old girl came to the casualty with complaints of fever, headache, rashes, and double vision. She had a few grouped vesicles involving the right side of the neck area adjacent to the midline above the suprasternal notch suggestive of herpes zoster. Extraocular movement was restrained on abduction in both eyes. Both eye anterior segment examination and fundus exam showed normal findings. The cerebrospinal fluid analysis suggested viral etiology. Magnetic resonance imaging of the brain showed normal findings. She was diagnosed with bilateral abducens nerve palsy as a result of herpes zoster virus. The skin lesions resolved and ocular movements became normal within 6 weeks.