LAUSR

Varicella zoster virus (VZV) (human herpesvirus 3) is a neurotropic double-stranded DNA virus, manifesting as varicella (chickenpox) at primary infection and herpes zoster (shingles) at recurrence. Prominent neurological complications of VZV reactivation include aseptic meningitis, meningoencephalitis, cerebellitis, radiculitis, transverse myelitis, sensorineural hearing impairment, secondary VZV vasculopathy, single or multiple cranial neuropathies (CN), and postherpetic neuralgia.1–4 Neurologic sequelae of VZV reactivation are primarily considered in immunocompromised and/or elderly individuals (Table 1). In this article, we describe the first case of acute herpes zoster orbital apex disorder with virologic evidence of VZV in an immunocompetent young adult. This case illustrates the complexity of VZV infections and the importance for neurologists to recognize the potential for central and peripheral nervous system involvement even in individuals without risk factors for VZV reactivation.