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Involvement of trochlear nerve during Varicella Zoster Virus (VZV) Infection has been rarely described, and always in association with skin rash. We describe the case of a patient with VZV infection presenting as isolated diplopia due to fourth cranial nerve palsy. The diagnosis has been obtained through the application of a standardized molecular diagnostic panel, and diplopia resolved after specific antiviral and corticosteroid therapy. This case evidences that clinicians should be aware of atypical VZV infection, even in the absence of the typical skin rash.

Citation

Raffaella Pisapia, Alessia Rianda, Andrea Mariano, Angela Testa, Simonetta Galgani, Laura Vincenzi, Amina Abdeddaim, Alessandra Oliva, Pasquale Narciso. Varicella zoster virus infection presenting as isolated diplopia: a case report. BMC infectious diseases. 2013 Mar 15;13:138

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PMID: 23497310

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