We describe a case presenting herpetic eruptions and pain in the left cranial and cervical regions, followed by right cranial polyneuropathy. The patient, a 66-yr-old male, developed a diphasic syndrome which was first characterized by herpetic eruptions on the whole of his left cranial and cervical regions with severe pain and left facial nerve palsy. Two weeks later, right multiple cranial nerve palsies of III, V, and VII and an increase in CSF protein appeared in a second phase. Neuroimaging technique (MRI) did not provide any evidence of brain involvement. The immediate use of steroid therapy led to improvement of the symptoms of cranial polyneuropathy. The clinical course suggests that reactivation of a latent herpes simplex virus may have been the etiologic cause of the cranial polyneuropathy. Steroid therapy should be applied to the treatment of cranial polyneuropathy in patients showing a similar pattern to this case.
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