What is Herpes Zoster Oticus

Herpes zoster oticus; facial nerve herpes, viral neuronitis)

Herpes zoster oticus is a rare treat herpes zoster virus infection of ganglia of the VIII. Cranial nerve and the “geniculate” ganglion of the 7th (facial) cranial nerve.

A herpes zoster (shingles) is caused by the reactivation of varicella zoster virus, Risk factors include reactivation immunodeficiency (cancer condition after chemotherapy or radiation) and HIV infection. Typically, the virus remains in a latent dorsal root ganglion, and the reactivation manifested as painful skin lesions after a dermatomal distribution. But often the virus remains latent in the geniculate ganglion and reactivation symptoms are caused, in which the 7th and 8th cranial nerve involved.

Herpes zoster oticus is a rare treat herpes zoster virus infection of ganglia of the VIII. Cranial nerve and the “geniculate” ganglion of the 7th (facial) cranial nerve. A herpes zoster (shingles) is caused by the reactivation of varicella zoster virus, Risk factors include reactivation immunodeficiency (cancer condition after chemotherapy or radiation) and HIV infection. Typically, the virus remains in a latent dorsal root ganglion, and the reactivation manifested as painful skin lesions after a dermatomal distribution. But often the virus remains latent in the geniculate ganglion and reactivation symptoms are caused, in which the 7th and 8th cranial nerve involved.

Symptoms and signs

Include The symptoms of herpes zoster oticus Severe ear pain (similar to Bell’s palsy) VerSchwindel that lasts days to weeks (which may be permanent, or partially or completely dissolves) temporary or permanent facial paralysis hearing loss in the coverage area of ??the sensitive Fazialisastes wide to cold sore from on the auricle and the external auditory canal. More rarely there is meningoencephalitis symptoms (such as headaches, confusion, stiff neck). Sometimes other cranial nerves may be involved.

Diagnosis

linical Investigation The diagnosis of herpes zoster oticus is clinical in general. In questionable viral etiology may be recovered swab material from the vesicles (for Virus Detection by direct immunofluorescence or culture), and a MRI be performed. Therapy may corticosteroids, antivirals and surgical relief Although there is no hard evidence that corticosteroids, antiviral agents or surgical relief to change something, they are the only therapeutic measures of potential use. When employed, the corticosteroid with 1 times 60 mg / day prednisone is p.o. started about 4 days and then slowly reduced within the next 2 weeks.

Both acyclovir 800 mg / day p.o. 5 times / day or 2 times valaciclovir 1 g / day p.o. over 10 days can shorten the course of disease and are routinely prescribed for immunocompromised patients. With diazepam (2-5 mg po every 4-6 h) can successfully suppress vertigo. For the pain oral opioids may be required. A post-herpetic neuralgia is treated with amitriptyline. In complete facial palsy (no visible facial movement or facial expressions) may be indicated a surgical decompression of the fallopian channel. But then only a> 90% decrease of the action potential has been demonstrated electro euro graphically before the procedure.

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