Stellate Ganglion-block Improved Abducense Nerve Palsy Associated with Facial Herpes Zoster

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Two patients with abducense nerve palsy secondary to herpes zoster infection on their facial region were cured by Stellate ganglion block (SGB). An 81-year-old woman suffering from facial pain, facial eruption and diplopia was admitted with the diagnosis of right trigeminal herpes zoster and right abducense nerve palsy. After the skin lesion resolved, the abducense nerve palsy and the facial pain remained. SGB using 1% mepivacaine was initiated once a day. The patient's right facial pain completely disappeared and her abducense nerve palsy also recovered with 15 attempts of right SGB. A 72-year-old woman who complained of left facial nerve palsy, left postauricular pain, eruption, and diplopia was diagnosed with Ramsay Hunt syndrome associated with left abducense nerve palsy. Although the facial nerve palsy was cured mostly by drug therapy, the abducense nerve palsy remained, left SGB using 1% mepivacaine was started once a day. Her abducense nerve palsy was improved by 13 attempts of left SGB. The therapeutic course of these two patients suggests that SGB is effective not only for pain due to herpes zoster but also for complications, and SGB performed at an early stage of the disease shortens the duration of the illness.
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