Successful response of non-recovering Ramsay Hunt syndrome to intravenous high dose methylprednisolone

Novel pre‐therapeutic scoring system using patient and haematological data to predict facial palsy prognosis

“…Sittel and Stennert reported that intravenous administration of high‐dose prednisolone (250 mg/d) was effective for treating acute idiopathic facial paralysis patients . Donati et al reported that high‐dose methylprednisolone (1 g/d) was effective for non‐recovering RHS patients. In order to improve the prognosis, it is worthwhile to consider increasing the dose of antiviral drug or corticosteroids in patients with a poor prognosis.…”

Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature

“…The incidence of RHS is 5 cases/100,000 people. 2 It affects mostly patients between the ages of 20 and 30, with no gender predilection. 1 Spontaneous remission of the facial palsy caused by VZV occurs only in a few cases - without proper treatment, only 20% achieve complete recovery.…”

“…The physiopathological mechanism is the reactivation of the VZV in the geniculate ganglion, with subsequent inflammation, edema, and compression of the VII cranial nerve. 2 Viral demyelination may also contribute to further damage of the nerve. 3 4 A viral prodrome or an upper respiratory tract infection might be the first symptoms, 5 evolving into severe pain in the pinna, acute facial hypotonia, and a herpetiform vesicular eruption on the pinna, external acoustic meatus, face, tongue, hard palate, neck, larynx, and oral mucosa.…”

“… 3 4 A viral prodrome or an upper respiratory tract infection might be the first symptoms, 5 evolving into severe pain in the pinna, acute facial hypotonia, and a herpetiform vesicular eruption on the pinna, external acoustic meatus, face, tongue, hard palate, neck, larynx, and oral mucosa. 2 Cochleovestibular impairment such as hypoacusis, tinnitus, and vertigo may occur. The involvement of other cranial nerves, such as V, IX, X, XI, and XII is rare.…”

Parálisis facial periférica en un paciente con lesiones vesiculosas unilaterales en el rostro

“…El pronóstico suele ser mejor cuanto antes se instaure el tratamiento 5,7,8 . Sin embargo, actualmente se ha discutido si realmente los agentes antivirales contribuyen a la resolución del cuadro 4,6,7 , y también es discutida la utilidad de la prednisona o dexametasona, debido a la contrariedad en el uso de corticoides en una enfermedad viral aguda 2,8 . No hay apenas estudios que hayan comparado el tratamiento con corticoides y antivirales por separado, y el tema no está del todo aclarado 3,6 , pero parece evidente que una terapia combinada y precoz disminuya las complicaciones 8 .…”