Herpes zoster oticus and facial paralysis ramsay hunt syndrome. The purpose of this paper is to present a severe case of herpes zoster oticus with complete paralysis of the facial nerve, involvement of both the vestibular and the cochlear branches of the eighth nerve and unusual findings in the cerebrospinal fluid. Two patients with herpes zoster oticus and facial paralysis are presented, in 1 of whom the geniculate ganglion showed at autopsy unequivocal pathological. Herpes zoster oticus is a common complication of shingles, an infection caused by the varicellazoster virus which is the virus that also causes chickenpox. Symptoms include pain and a variety of other problems in the.
This study adopted a test battery of cranial nerves cns vii and viii comprising a facial nerve function test, audiometry, a caloric test, and ocular and cervical vestibularevoked myogenic potential ovemp and cvemp, respectively tests to assess the function of cns vii and viii comprehensively so as to predict facial nerve recovery in patients with herpes zoster oticus hzo. Shingles occurs in people who have had chickenpox and in whom the varicellazoster virus becomes active again. Methods eight patients three men and five women suffered from auricular vesicles, otalgia, and facial palsy, and five of them also had vertigo. Evaluation and management of herpes zoster ophthalmicus. Ocular nervous system lesions can also be involved by herpes zoster, but isolated trochlear nerve lesion involvement is extremely rare. Herpes zoster oticus with meningitis masquerading as. Herpes zoster ophthalmicus is reactivation of a varicella zoster virus infection involving the eye. Herpes zoster oticus produces facial paralysis with a low recovery rate. Herpes zoster hz ist eine sehr haufige erkrankung, welche be. Human alphaherpesvirus 3 hhv3, usually referred to as the varicellazoster virus vzv, is one of nine herpesviruses known to infect humans. It causes chickenpox varicella, a disease most commonly affecting children, teens, and young adults, and shingles herpes zoster in adults.
Objectivehypothesis this study aims to analyze which division of vestibular nerve in the internal auditory canal is responsible for inducing vertigo in patients with herpes zoster oticus hzo methods eight patients three men and five women suffered from auricular vesicles, otalgia, and facial palsy, and five of them also had vertigo. Commonly referred to as ramsay hunt syndrome type ii, herpes zoster oticus is a disease that affects a bundle of nerve cells in the ear. Shingles herpes zoster symptoms, causes and treatments. Is caused by vzv infection of the head and neck involving the facial nerve seventh cranial nerve. Shingles, or herpes zoster, is a painful rash caused by the chickenpox virus. Each patient received a battery of tests, including. Acyclovir, a specific virostatic drug, was given intravenously in five herpes zoster oticus patients, and in three of them w. Herpes zoster oticus hzo is a viral infection of the ear. Its caused by the varicella zoster virus, the same virus. Herpes zoster shingles is reactivation of varicella zoster virus infection. Nov 15, 2007 zoster ophthalmicus n29, meningoencephalitis n22, and zoster oticus n23 11 cases had ramsay hunt syndrome accounted for 59% of all complications n115. The natural history of herpes zoster oticus in patients with a poor prognosis was improved if a transmastoid extralabyrinthine subtemporal decompression of the labyrinthine segment of the facial nerve was performed within 10 days of onset of the paralysis. We studied 28 patients with herpes zoster oticus prospectively over the six.
There may also be eye pain, eye redness, and light sensitivity. The incidence of hospitalization suggests that at least 1 in every 100 children with herpes zoster is hospitalized and that at least 1 in every 250 immunocompetent children with. When used alone the term may refer to either herpes simplex or herpes zoster. Acute unilateral vestibular loss as onset of zoster oticus infection. The authors, after careful examination and observation of the case, revealed a series of unusual findings. This page may contain terms or definitions that are offensive or inappropriate for some readers. Methodsresults systematic searches of pubmed medline. Symptoms include pain and a variety of other problems in the ear, as well as problems in the mouth and eyes. Zoster oticus manifests most often as severe otalgia and associated cutaneous vesicular eruption.
Herpes zoster ophthalmicus msd manual professional edition. The case of herpes zoster oticus reported by johnson and zonderman1 deserves special attention. Nov 15, 2018 herpes zoster oticus hz oticus is a viral infection of the inner, middle, and external ear. Caused by the reactivation of the varicellazoster virus vzv, zoster usually presents as a painful dermatomal rash. Herpes zoster oticus an overview sciencedirect topics. Herpes zoster oticus is an uncommon manifestation of herpes zoster that affects the 8th cranial nerve ganglia and the geniculate ganglion of the 7th facial cranial nerve. Sep 21, 2015 ramsay hunt syndrome herpes zoster oticus or auricular herpes zoster described here. Shingles herpes zoster is a dermatomal rash with painful blistering that is caused by the reactivation of the varicella zoster virus. Ramsay hunt syndrome journal of neurology, neurosurgery.
Herpes zoster oticus article about herpes zoster oticus by. Symptoms generally include a rash of the forehead with swelling of the eyelid. Shingles is an infection caused by the varicella zoster virus, which is the virus that causes chickenpox. Human alphaherpesvirus 3 hhv3, usually referred to as the varicella zoster virus vzv, is one of nine herpesviruses known to infect humans. We found that the results of measuring tear production, submandibular salivary flow, the response to maximal stimulation, and evoked electromyography gave us sufficient information to group these patients according to prognosis either unfavorable or favorable for. We considered at that later moment the infection as a herpes zoster infection herpes zoster oticus or auricular herpes zoster, ramsay hunt syndrome and we continued intravenous administration of vasodilators and group b vitamins.
Herpes zoster oticus is a radicular neuralgia and vesicular eruption around the ear with a facial palsy. Since that time, a number of variations on the classic triad have been described. Oct 15, 2014 patient was included in an antidiabetes treatment protocol. Herpes zoster annals of internal medicine american. The most common example of this in the head and neck is ramsay hunt syndrome rhs, or herpes zoster oticus, which incorporates a triad of facial nerve palsy, otalgia and a vesicular rash in the ear or on the palate, tongue or pinna. Herpes zoster oticus information page national institute of. Most patients with herpes zoster oticus have diverse symptoms associated with dysfunction of the 7th and 8th cranial nerves. Methodsresults systematic searches of pubmed medline, scopus embase and. Its caused by the varicellazoster virus, the same virus. Acute unilateral vestibular loss as onset of zoster oticus. In 1907 ramsay hunt reported the clinical syndrome of herpes zoster oticus hzo, a lowermotorneuron type of facial paralysis, otalgia, and auricular vesicles, which bears his name.
Herpes zoster oticus definition of herpes zoster oticus. Zoster ophthalmicus n29, meningoencephalitis n22, and zoster oticus n23 11 cases had ramsay hunt syndrome accounted for 59% of all complications n115. Shingles is an infection caused by the varicellazoster virus, which is the virus that causes chickenpox. The relief of pain and residual disability have been marked.
Herpes zoster ophthalmicus is reactivation of a varicellazoster virus infection involving the eye. Herpes zoster oticus is a rare type of shingles a viral infection of a nerve that causes a painful rash on the face including the ear. Ramsay hunt syndrome type 2, also known as herpes zoster oticus, is a disorder that is caused by the reactivation of varicella zoster virus in the geniculate ganglion, a nerve cell bundle of the facial nerve ramsay hunt syndrome type 2 typically presents with inability to move many facial muscles, pain in the ear, taste loss on the front of the tongue, dry eyes and mouth, and a vesicular rash. Hz oticus manifests as severe otalgia and associated cutaneous vesicular eruption, usually of the external canal and pinna. Symptoms and signs, which may be severe, include dermatomal forehead rash and painful inflammation of all the tissues of the anterior and, rarely, posterior structures of the eye. Covid19 is an emerging, rapidly evolving situation. Herpes zoster oticus also known as ramsay hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. We considered at that later moment the infection as a herpes zoster infection herpes zoster oticus or auricular herpes zoster, ramsay hunt syndrome and we continued intravenous administration of vasodilators and group b vitamins, but without cortisone due to hyperglycaemia. Herpes zoster oticus is a viral infection of the inner, middle and external ear. It is caused by a virus called the varicellazoster virus. Ramsay hunt syndrome type 2, also known as herpes zoster oticus, is a disorder that is caused by the reactivation of varicella zoster virus in the geniculate ganglion, a nerve cell bundle of the facial nerve.
Test battery of cranial nerves vii and viii for assessing. Herpes zoster oticus is caused by the spread of the virus to facial nerves and can cause intense ear pain. Herpes zoster oticus is a unique variant of viral labyrinthitis and is caused by reactivation and infection of the vestibulecochlear nerve by the latent varicella. When associated with facial paralysis, the infection is called ramsay hunt syndrome.
In phase 3 clinical trials, the vaccine had 70% efficacy at preventing herpes zoster among adults aged 50 to 59 years, but efficacy declined with age, to 38%. What is herpes zoster oticus, also known as ramsay hunt. Varicellazoster virus adult and adolescent opportunistic. Background patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. Atypical presentations and zosteriform herpes simplex may present diagnostic challenges to clinicians. Shingles occurs in people who have had chickenpox and represents a reactivation of the dormant varicellazoster virus. Mar 27, 2019 herpes zoster oticus, also called ramsay hunt syndrome or ramsay hunt syndrome type ii, is a common complication of shingles. Herpes zoster oticus hz oticus is a viral infection of the inner, middle, and external ear.
Herpes zoster of the head and neck volume 86 issue 10 r. Schmerzen, varicellazostervirus, varizellen, aciclovir. Herpes zoster oticus is a common complication of shingles, an infection caused by the varicella zoster virus which is the virus that also causes chickenpox. Steroids have been shown to be the treatment of choice in other forms of herpes zoster. Shingles herpes zoster is a dermatomal rash with painful blistering that is caused by the reactivation of the varicellazoster virus. Other symptoms may include hearing loss, vertigo feeling that the room is spinning, tinnitus hearing abnormal sounds, nausea, vomiting, loss of taste in. Herpes zoster oticus ramsay hunt syndrome in children. Herpes zoster oticus, also called ramsay hunt syndrome or ramsay hunt syndrome type ii, is a common complication of shingles. Shingles is an infection of a nerve and the area of skin supplied by the nerve. Anyone who has had chickenpox in the past may develop shingles. Pdf herpes zoster oticus also known as ramsay hunt syndrome is a rare complication of herpes zoster in which reactivation of latent. Dawes skip to main content accessibility help we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Sep 05, 2019 a onedose attenuated livezoster virus vaccine zoster vaccine live, zvl, zostavax for prevention of herpes zoster is fdaapproved for use in immunocompetent adults aged. Aug 07, 2018 the original version pdf is appended to this article as a supplement.
Shingles occurs in people who have had chickenpox and in whom the varicella zoster virus becomes active again. Herpes zoster oticus information page national institute. Aug 19, 2016 herpes zoster oticus is caused by the spread of the virus to facial nerves and can cause intense ear pain. Herpes zoster is a common diagnosis in the emergency department ed. Herpes zoster oticus definition of herpes zoster oticus by. Varicella zoster virus vzv is an exclusively human neurotropic herpesvirus that causes varicella chickenpox during primary infection, after which the virus becomes latent in cranial nerve, dorsal root, and autonomic ganglia along the entire neuraxis. Nov 15, 2007 herpes zoster is a common diagnosis in the emergency department ed. Bei 19 patienten mit einem zoster oticus fand sich in 2 fallen eine homolaterale pankochleare. Primary care providers and hospitalists frequently encounter older or immunocompromised patients with herpes zoster accompanied by debilitating pain. Objectivehypothesis this study aims to analyze which division of vestibular nerve in the internal auditory canal is responsible for inducing vertigo in patients with herpes zoster oticus hzo. Herpes zoster oticus genetic and rare diseases information. Menachem gross, ron eliashar, in orofacial pain and headache, 2008. Herpes zoster oticus article about herpes zoster oticus. Jan 01, 2000 in 1907 ramsay hunt reported the clinical syndrome of herpes zoster oticus hzo, a lowermotorneuron type of facial paralysis, otalgia, and auricular vesicles, which bears his name.
The strict definition of the ramsay hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear zoster oticus or in the mouth. The original version pdf is appended to this article as a supplement. Ramsay hunt syndrome rhs or herpes zoster oticus hzo is a rare clinical entity with a global incidence rate of 5 in 1,00,000. The initial infection with vzv usually occurs early in life, presenting as chickenpox, after which the virus remains dormant in the dorsal root ganglia.
Ramsay hunt cerebellar syndrome dyssynergia cerebellaris myoclonica, dyssynergia cerebellaris progressiva, dentatorubral degeneration is the rare entity characterised by seizures, cognitive impairment, action myoclonus and progressive ataxia. Their records particularly concern items such as the sites of the herpetic eruptions, the primary. Is it possible herpes zoster oticus induced diplopia. Ramsay hunt syndrome is rare in children and affects both sexes equally. Ramsay hunt syndrome herpes zoster oticus s karthiga kannan, j eugenia sherubin, s sajesh, kp gopakumar. The chickenpox virus is also called varicellazoster. The strict definition of the ramsay hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear herpes zoster oticus or in the mouth. J ramsay hunt, who described various clinical presentations of facial paralysis and rash, also recognised other frequent symptoms and signs such as tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus. Risk factors for reactivation include immunodeficiency secondary to cancer, chemotherapy. Herpes zoster ophthalmicus hzo, also known as ophthalmic zoster, is shingles involving the eye. Herpes zoster oticus ear, nose, and throat disorders. In addition to skin or mucosal involvement, vzv reactivation commonly affects the ophthalmic division of the trigeminal nerve and subsequently the eye. It is typically a complication of herpes zoster, or shingles.
85 1415 276 788 774 794 490 422 695 696 840 750 618 233 1179 724 382 345 1470 835 1256 382 1351 497 468 1301 1461 1323 475 260 116 808 1456