Treatment of ramsay hunt syndrome with acyclovir‐prednisone: Significance of early diagnosis and treatment

Murakami, Shingo; Hato, Naohito; Horiuchi, Joji; Honda, Nobumitsu; Gyo, Kiyofumi; Yanagihara, Naoaki

doi:10.1002/ana.410410310

Cited by 268 publications

(165 citation statements)

References 18 publications

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“…The most recommended therapy for RHS is the combination of acyclovir and prednisone [3]. Acyclovir is an effective antimicrobial agent against actively replicating herpes zoster viruses.…”

Section: Discussionmentioning

confidence: 99%

“…A study on 80 RHS patients with different levels of severity treated with acyclovir-prednisone combination showed complete facial recovery, i.e., House grade I, in 52% patients, no matter what their pre-treatment gradings were [3]. Methylprednisolone has a higher affinity to glucocorticoid receptors, and a higher anti-inflammatory action when compared with the prednisone, prednisolone, or hydrocortisone [11].…”

Section: Discussionmentioning

confidence: 99%

“…Early diagnosis and accurate treatment for patients with idiopathic facial palsy (Bell palsy) and Ramsay Hunt syndrome may accelerate recovery and prevent possible complications. Without treatment, full recovery of the facial paralysis occurs in as little as 20% of cases; this is much improved if treatment is started within 72 hours [3]. Among the agents most frequently used to treat these conditions are steroids, antiviral agent's vasodilators, and multivitamins.…”

Section: Introductionmentioning

confidence: 99%

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Ramsay Hunt Syndrome – A Diagnostic Dilemma

Sakthivel¹,

Singh²,

Smriti³

et al. 2017

JOENTR

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Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) or in the mouth. Ramsay Hunt Syndrome (RHS) is a rare, severe complication of varicella zoster virus (VZV) reactivation in the geniculate ganglion. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. It is also accompanied by other frequent symptoms like tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus due to the close proximity of the geniculate ganglion to the vestibulocochlear nerve within the bony facial canal. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction.We describe a 23 year old female who was initially misdiagnosed as Bell's palsy and later developed vesicles on the pinna which led to a diagnosis of RHS and successfully treated with acyclovir and steroids.

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“…The most recommended therapy for RHS is the combination of acyclovir and prednisone [3]. Acyclovir is an effective antimicrobial agent against actively replicating herpes zoster viruses.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ramsay Hunt Syndrome – A Diagnostic Dilemma

Sakthivel¹,

Singh²,

Smriti³

et al. 2017

JOENTR

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“…Herpes Zoster is seen a disease of older people (> 60 years old). The severity and incidence of the disease is depend on the cellular immunity of the patient [2]. This RHS type 2 is shingles of the geniculate ganglion, means the herpes zoster virus lies dormant in various nerve cells in the body and in check by the patient's immune system.…”

Section: Discussionmentioning

confidence: 99%

A rare case of Herpes zoster oticus in an immunocompetent patient

Dhavalshankh¹,

Dhavalshankh²,

Mhasvekar³

2012

Our Dermatol Online

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IntroductionRamsay Hunt syndrome (RHS) is first described by James Ramsay Hunt in 1907 [1]. It is caused by the reactivation of latent varicella-zoster virus (VZV) that has remained dormant within sensory root ganglia (commonly the geniculate ganglion) of the sensory branch of the facial nerve. Involvement of sensory branch of the geniculate ganglion of facial nerve leads Herpes zoster (HZ) oticus which is also known as RHS. Individuals with decreased cell-mediated immunity resulting from carcinoma, radiation therapy, chemotherapy or human immunodeficiency virus (HIV) infection are at greater risk for reactivation of latent VZV. Physical stress and emotional stress often are cited as precipitating factors. Incidence and clinical severity increases when host immunity is compromised. However it is uncommon to see Herpes zoster oticus in healthy individuals. In this report, we describe the clinical course of a patient who presented with Herpes zoster oticus in the absence of a known immunosuppressive condition. A brief review of literature on this topic is also presented. Case ReportA previously healthy 65-year old man presented with a 3-days history of vesicular lesions with erythematous base on neck. It was followed by the spread of vesicular eruption to involve external external auditory meatus of right side, and pinna over next 2-days. These are fluid filled vesicular eruptions which bust and break down on 2nd-3rd day with subsequent scab formation. There is no facial weakness. On examination, there was no lower motor neuron facial palsy. A neurologic examination revealed no weakness in the marginal mandibular branch of the left facial nerve. There is no any sign of loss of ipsilateral nasolabial fold or weakness in the temporal branch of the facial nerve. There were painful adherent crusts and scabs in left conchae and external auditory meatus (Fig. 1), associated with unclear hearing of left ear. The oral cavity and oropharynx were normal. Ocular examination demonstrated no nystagmus and normal conjunctiva. He has given history of stressful life events (sudden 3 deaths in family) in past 4 months. Review of systems was negative. The patient is not able to tell history of chickenpox during childhood or any recent exposure to it. There was no past history of diabetes, cardiac or pulmonary disease or lymphoma. The patient has not been on immunosuppressive or other medications. There is history of Psoriasis 2 years back showing on and off symptoms but on regular treatment. Patient is alcoholic, habit of tobacco chewing and occasional Pan chewing. On examination, the patient was afebrile (37.4°C). He had vesicles but not pustules, with crusting and swelling, in the distribution of the cervical division of VII (facial) cranial nerve. The left pinna is swollen, tender and red. There was no tympanic membrane involvement. Vesicles and scabs in various stages were also present lateral side of neck, in front of sternum and external ear ( Fig. 1) and behind Right pinna (Fig. 2) AbstractHerpes zoster oticus in healthy pe...

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“…Dickens et al in their study of 7 patients treated with intravenous acyclovir achieved complete response in 57% of patients [5). Murakami et al in a large study involving 80 patients used a combination of intravenous/oral acyclovir with prednisolone for 7 days [6). In 53% of patients complete recovery was achieved.…”

Section: Discussionmentioning

confidence: 99%

Ramsay Hunt Syndrome Treated with Oral Acyclovir

Singh

2003

Medical Journal Armed Forces India

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Treatment of ramsay hunt syndrome with acyclovir‐prednisone: Significance of early diagnosis and treatment

Cited by 268 publications

References 18 publications

Ramsay Hunt Syndrome – A Diagnostic Dilemma

Ramsay Hunt Syndrome – A Diagnostic Dilemma

A rare case of Herpes zoster oticus in an immunocompetent patient

Ramsay Hunt Syndrome Treated with Oral Acyclovir

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