TABLE 1

Complications of herpes zoster

ComplicationsComment
Postherpetic neuralgiaMost common complication of herpes zoster
Manifests as persistent pain beyond 90 days of rash
Herpes zoster ophthalmicusVision-threatening complication from involvement of ophthalmic division of cranial nerve V
High risk of vision loss if antiviral therapy is not promptly initiated
Acute retinal necrosisNecrotic infection of the retina that often leads to profound vision loss
Caused by herpes viruses, most often by herpes zoster or varicella
Ramsay Hunt syndrome (herpes zoster oticus)Major otologic complication of herpes zoster from viral reactivation within the geniculate ganglion, with potential spread to cranial nerves V, VII, VIII, IX, and X
Often manifests as the triad of facial palsy, ear pain, and otic vesicular lesions
Miscellaneous neurologic complicationsStroke syndromes, motor neuropathy, myelitis, encephalitis, central nervous system vasculitis
Disseminated infectionDisseminated varicella infection with potential for visceral target organ involvement with possible widespread cutaneous involvement
  • Based on information from references 1 and 2.