The risk for stroke increases significantly in the weeks after the
onset of herpes zoster, especially cases of zoster affecting the
distribution of the trigeminal nerve, according to a Clinical
Infectious Diseases study.
Using a U.K. general practice database, researchers studied some 6500
patients who had zoster and subsequent stroke. The observations began
in the baseline period before the onset of zoster and extended for at
least a year.
Patients were at greatest risk in the first 4 weeks after zoster
onset, having an incidence ratio of 1.63 relative to baseline. The
ratio in weeks 13 through 26 declined to 1.23, becoming nonsignificant
thereafter. Stroke risks were especially strong after zoster
Roughly half the patients received oral antiviral treatment, and among
those, there was a protective effect. The authors, suspecting a role
for vasculopathy, encourage improvement in what they see as a
relatively low rate of treatment with antivirals.
Clinical Infectious Diseases article