Definition
The causative agent of shingles is the varicella zoster virus (VZV), which belongs to the herpes virus family. It is transmitted via the air and inhaled (droplet infection), but can also spread via contact with virus-containing vesicles or crusts (smear infection). In the case of initial infection, the disease often manifests itself in childhood as chickenpox.
This is accompanied by small, usually raised, round-oval, red spots and blisters on the trunk, face, arms and legs, as well as headache, aching limbs and fever. Once healed, the viruses may reactivate many years later and cause the clinical picture of shingles. The viruses spread along the nerve fibers. Often the head is also affected, resulting in specific symptoms with sometimes serious complications.
Causes of shingles on the head
After healing of a chickenpox disease, the varicella zoster virus (VZV) remains in the body and settles mainly in the area of nerve fibers. Both the nerves in the area of the spinal column and the cranial nerves can be affected. The infection subsequently runs without symptoms for a long time.
However, in the case of a weakened immune system (e.g. in old age), stress, trauma or numerous other causes, the viruses may be reactivated. In the area of the head, the viruses migrate along the nerve fibers (cranial nerves) in the direction of the (sensory) organs and the skin. At the same time, the nerve cells are damaged. Frequently affected cranial nerves are the trigeminal nerve (sensitive supply to the face), the facial nerve (supply to the facial muscles) and the vestibulocochlear nerve (auditory and vestibular nerve). If they spread to the affected sensory organs, complications such as impaired vision, hearing and balance as well as severe pain in the skin area can result.
Diagnosis of shingles on the head
The diagnosis is based on the typical symptoms of a VZV disease. In the process, so-called herpes zoster blisters form in the area of the skin supplied by the respective nerves. At the same time, there is often severe nerve pain in the area of the affected skin.
Sensory disturbances (paresthesias) are also possible. In individual cases, further diagnostics may be necessary (e.g. CSF or blood tests). An already healed chickenpox disease can confirm the diagnosis of shingles. However, it should be borne in mind that chickenpox can also progress completely without symptoms during childhood.
