Trigeminal herpes zoster and Ramsay Hunt syndrome in an elderly adult: Presentation with prodromal toothache.

Objective: This article describes an atypical herpes zoster (HZ) infection heralded by prodromic dental pain.
Background: Trigeminal HZ is associated with any of the three divisions of the trigeminal nerve, and Ramsay Hunt syndrome is a rare variant of HZ infection of the ear, often accompanied with unilateral facial nerve palsy.
Materials and Methods: An 87-year-old man sought remedy for tooth-like pain. Within a week, he developed cutaneous, intraoral and otic eruptions, hearing loss, and mild facial palsy.
Results: After ruling out odontogenic pain, he was diagnosed with trigeminal HZ and Ramsay Hunt syndrome.
Conclusion: Herpes zoster infection should be included as a possible aetiologic factor with atypical presentations of odontogenic pain. Diagnosis of trigeminal HZ infection and the Ramsay Hunt syndrome may lead to timely intervention with antivirals and improved patient outcomes.
(© 2018 Gerodontology Association and John Wiley & Sons Ltd.)