眼球運動障害をきたした眼部帯状疱疹の1例

A case of herpes zoster ophthalmicus with impaired ocular motility

要約　目的：眼部の帯状疱疹に眼球運動障害が併発した1症例の報告。

症例：66歳の男性が2週間前からの頭痛で脳神経外科を受診し，前額部の帯状疱疹と診断され，入院のうえアシクロビルなどでの治療を受けた。入院5日目に左眼に眼瞼下垂，眼球の外転位，内転障害が生じ，左の動眼神経麻痺が疑われた。その翌日に左眼の外転制限が生じた。MRIなどによる画像検査で頭蓋内に格別の異常はなく，眼部帯状疱疹による外眼筋麻痺と診断された。アシクロビルとプレドニゾロンの全身投与を行い，入院から11日後に眼瞼と眼球運動障害は消失した。以後7か月後の現在まで再発はない。

結論：眼部帯状疱疹に併発した眼瞼と眼球運動障害は，早期の診断と治療により，速やかに寛解した。

Abstract　Purpose：To report a case of herpes zoster ophthalmicus with impaired ocular motility.

Case：A 66-year-old male had headache for 2 weeks and was diagnosed with herpes zoster ophthalmicus at a department of neurosurgery. He was hospitalized and started receiving acyclovir. Five days later, he developed ptosis of left eyelid, deviation of left eye to the left, and impaired inward movement. The findings were suggestive of left oculomotor palsy. He developed limited outward movement of the left eye the next day. Diagnostic imaging, including magnetic resonance imaging, showed normal findings of the brain. He was diagnosed with extraocular muscle palsy secondary to herpes zoster. Treatment with acyclovir and prednisolone was followed by cure of eyelid and ocular movement disorders on day 11 of hospitalization. There has been no recurrence for 7 months until present.

Conclusion：Early diagnosis and treatment was followed by prompt cure of eyelid and ocular motility disorders secondary to herpes zoster ophthalmicus.