# Trigeminal Neuralgia Secondary to Herpes Simplex Virus Type 1 Infection Treated With Oral Acyclovir

## TL;DR

A 30-year-old woman's trigeminal neuralgia was caused by HSV-1 and resolved with acyclovir, showing the importance of considering viral causes.

## Contribution

Demonstrates HSV-1 reactivation as a rare cause of trigeminal neuralgia treatable with antiviral therapy.

## Key findings

- HSV-1 reactivation can cause trigeminal neuralgia without neurovascular compression.
- Oral acyclovir resolved TN symptoms without the need for anticonvulsants.
- Early antiviral treatment may provide sustained relief in HSV-associated TN.

## Abstract

Trigeminal neuralgia (TN) is characterized by episodic electric, shock-like facial pain. Though often idiopathic, herpes simplex virus type 1 (HSV-1) reactivation can rarely cause symptomatic TN. We report the case of a 30-year-old woman who developed oral HSV-1 lesions followed by right-sided TN pain. MRI of the brain did not reveal neurovascular compression. TN pain completely resolved with oral acyclovir treatment alone, without anticonvulsants. This highlights the importance of considering atypical etiologies such as HSV-1 reactivation in TN evaluation. Early antiviral therapy may treat underlying inflammation and provide sustained symptom relief in HSV-associated TN.