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Herpes Reactivation and Ophthalmoplegia From Pituitary Adenoma Invading the Cavernous Sinus

Herpes Reactivation and Ophthalmoplegia From Pituitary Adenoma Invading the Cavernous Sinus Abstract Ocular motor nerve palsies are common in patients with herpesvirus reactivation. The palsies are caused by an ischemic vasculitis affecting the ocular motor nerves along with the trigeminal nerve. On rare occasions, a tumor in the cavernous sinus can produce ophthalmoplegia and skin manifestations of herpesvirus infection. Report of a Case. —An 82-year-old man was found by a family member to be mildly confused and complaining of right orbital pain. On examination he had a fever of 39.8°C and herpetic vesicles on the right side of the nose and upper lip. Skin testing disclosed mild hypoesthesia involving the right ophthalmic (V1) and maxillary (V2) trigeminal divisions. Visual acuity was 20/20 OU. The patient was unable to open his right eye (Fig 1). It was completely ophthalmoplegic with a fixed 6.5-mm pupil.The patient's ophthalmoplegia was initially attributed to herpesvirus. However, a computed tomographic scan performed 2 days later References 1. Pazin GJ, Ho M, Jannetta PJ. Reactivation of herpes simplex virus after decompression of the trigeminal nerve root . J Infect Dis . 1978;138:405-409.Crossref 2. Nabors NW, Francis CK, Kobrine AI. Reactivation of herpesvirus in neurosurgical patients . Neurosurgery . 1986;19:599-603.Crossref 3. Edgerton AE. Herpes zoster ophthalmicus . Arch Ophthalmol . 1945;34:40-62.Crossref 4. Lavin PJM, Younkin SG, Kori SH. The pathology of ophthalmoplegia in herpes zoster ophthalmicus . Neuro-Ophthalmol . 1984;4:75-80.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Herpes Reactivation and Ophthalmoplegia From Pituitary Adenoma Invading the Cavernous Sinus

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References (6)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1991.01080030025022
Publisher site
See Article on Publisher Site

Abstract

Abstract Ocular motor nerve palsies are common in patients with herpesvirus reactivation. The palsies are caused by an ischemic vasculitis affecting the ocular motor nerves along with the trigeminal nerve. On rare occasions, a tumor in the cavernous sinus can produce ophthalmoplegia and skin manifestations of herpesvirus infection. Report of a Case. —An 82-year-old man was found by a family member to be mildly confused and complaining of right orbital pain. On examination he had a fever of 39.8°C and herpetic vesicles on the right side of the nose and upper lip. Skin testing disclosed mild hypoesthesia involving the right ophthalmic (V1) and maxillary (V2) trigeminal divisions. Visual acuity was 20/20 OU. The patient was unable to open his right eye (Fig 1). It was completely ophthalmoplegic with a fixed 6.5-mm pupil.The patient's ophthalmoplegia was initially attributed to herpesvirus. However, a computed tomographic scan performed 2 days later References 1. Pazin GJ, Ho M, Jannetta PJ. Reactivation of herpes simplex virus after decompression of the trigeminal nerve root . J Infect Dis . 1978;138:405-409.Crossref 2. Nabors NW, Francis CK, Kobrine AI. Reactivation of herpesvirus in neurosurgical patients . Neurosurgery . 1986;19:599-603.Crossref 3. Edgerton AE. Herpes zoster ophthalmicus . Arch Ophthalmol . 1945;34:40-62.Crossref 4. Lavin PJM, Younkin SG, Kori SH. The pathology of ophthalmoplegia in herpes zoster ophthalmicus . Neuro-Ophthalmol . 1984;4:75-80.Crossref

Journal

Archives of Ophthalmology – American Medical Association

Published: Mar 1, 1991

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