A 47-year-old left-handed man had chickenpox at approximately 7 years of age. Since then, he had intermittent painful blisters on his right hand, as well as painful blisters on the right posterior neck associated with unilateral right-sided headaches. At the age 41, he had a cerebral infarction. He was found to have an occluded right ICA and 90% left ICA stenosis. He had a left CEA. A year later, he developed a right peripheral facial palsy associated with right ear vesicles. Over the subsequent years, he had recurrent episodes right hand and posterior neck vesicular rashes. He also had a recurrent left peripheral facial paralysis a few years after his initial stroke.