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Recurrent Cavernous Sinus Syndrome: A Case Report of a Rare Clinical Entity

N. Singhal, Vinay Agarwal, Mayank Agarwal

Neurology India Case Report, 2025

Abstract

Herpes zoster (HZ) involvement of the cavernous sinus is an extremely rare clinical entity. We report the case of a 30-year-old male presenting with acute unilateral ophthalmoplegia and periorbital pain, followed by a herpetic rash indicative of HZ ophthalmicus (HZO). Notably, the patient had a prior history of bilateral cavernous sinus inflammatory pseudotumor diagnosed with Tolosa-Hunt syndrome 5 years earlier. Prompt intervention with corticosteroids and antiviral medications produced substantial clinical progress. This case emphasizes the rare correlation between HZO and involvement of the cavernous sinuses as well as the necessity of considering fundamental immunological variables into account in recurrent presentations.

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