This is a case of herpes zoster opthalmicus with involvement of the right trigeminal nerve presented with stroke and hemiplegia secondary to HZV vasculopathy. The author discusses clinical manifestation, the subtle diagnosis, and treatment of HZV vasculopathy. Anti-VZV antibodies along with the VZV-DNA sequencing using the new PCR technology are key to diagnosis when VZV infection presented without the typical rash.
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