acyclovir and Earache

Topics: Acetates; Acyclovir; Age Factors; Aged; Aged, 80 and over; Amines; Analgesics; Antiviral Agents; Cyclohexanecarboxylic Acids; Diagnosis, Differential; Earache; Fever; Gabapentin; gamma-Aminobutyric Acid; Herpes Zoster; Humans; Male; Oxycodone; Pain; Patient Selection; Polymerase Chain Reaction; Risk Factors; Valacyclovir; Valine

To evaluate the effect of prednisolone and valacyclovir on ipsilateral pain around the ear and in the face or neck in Bell's palsy. The incidence and intensity of pain during the first 2 months of palsy and its prognostic value were also assessed.. Prospective, randomized, double-blind, placebo-controlled, multicenter trial.. Sixteen tertiary referral centers in Sweden and 1 in Finland.. Data are part of the Scandinavian Bell's palsy study; 829 patients aged 18 to 75 years with onset of palsy within 72 hours were included. Follow-up time was 12 months.. Patients were assigned to 1 of 4 treatment arms in a factorial fashion: placebo plus placebo; prednisolone 60 mg daily for 5 days, then tapering for 5 days, plus placebo; valacyclovir 1,000 mg 3 times daily for 7 days plus placebo; or prednisolone plus valacyclovir.. Pain was registered on a visual analog scale within 72 hours, at Days 11 to 17, 1 month, and 2 months. Facial function was assessed with the Sunnybrook and House-Brackmann systems.. Prednisolone and/or valacyclovir did not significantly affect the incidence or intensity of pain during the first 2 months. Pain was registered in 542 (65%) of 829 patients. At 2 months, 53 (8%) of 637 patients still reported pain. Subjects with pain at Days 11 to 17 had lower facial recovery rates at 12 months than those with no pain (p < 0.0001).. Prednisolone and/or valacyclovir did not affect the incidence or intensity of ipsilateral pain in Bell's palsy. The incidence of pain was similar during the first 2 weeks and then decreased. Presence of pain at Days 11 to 17 indicated a worse prognosis for facial recovery.

Topics: Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Bell Palsy; Double-Blind Method; Earache; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neck Pain; Pain; Pain Measurement; Prednisolone; Prognosis; Prospective Studies; Treatment Outcome; Valacyclovir; Valine

Topics: Acyclovir; Aged; Anti-Inflammatory Agents; Antiviral Agents; Earache; Exanthema; Facial Dermatoses; Facial Paralysis; Herpes Zoster Oticus; Humans; Male; Prednisolone; Treatment Outcome

We herein present a case of 6-year-old female demonstrating atypical Ramsay-Hunt syndrome. She presented with an earache, severe vertigo, and vomiting at onset, and thereafter, herpes zoster oticus appeared. No facial nerve palsy was seen. She was vaccinated for varicella and had no past history of apparent varicella infection. The patient showed positive IgG and negative IgM serum antibodies for varicella-zoster virus (VZV). An analysis of VZV-DNA from the patient's ear lesion using alleric discrimination real-time PCR identified a wild-type strain of VZV. We diagnosed her to have atypical Ramsay-Hunt syndrome caused by reactivation of the VZV. Aciclovir and prednisolone were administered, and she recovered completely. This case indicates that Ramsay-Hunt syndrome could be caused by a VZV infection after vaccination, even though its frequency is low. Ramsay-Hunt syndrome may thus be considered as one of causes of sudden onset vertigo in children.

Topics: Acyclovir; Chickenpox Vaccine; Child; Diagnosis, Differential; Earache; Female; Herpes Zoster Oticus; Herpesvirus 3, Human; Humans; Prednisolone; Severity of Illness Index; Treatment Outcome; Vertigo; Vomiting

Ramsay-Hunt syndrome, herpes zoster oticus (HZO), derived its name from James Ramsay Hunt, who first described it in 1907. It is classically characterized by acute peripheral facial paralysis, herpetic eruptions on the auricle, and vestibulocochlear dysfunction due to the reactivation of varicella zoster virus (VZV). In this Case Report, the authors describe an HZO patient with simultaneous VZV encephalitis. To date, only eight cases of HZO associated with VZV encephalitis have been reported in the English literature. Therefore, the authors discuss all the aspects of this rare entity, including clinical examination, radiological evaluation, laboratory evaluation, and treatment options.

Topics: Acyclovir; Adult; Dextrans; Drug Administration Schedule; Drug Therapy, Combination; Earache; Encephalitis, Varicella Zoster; Facial Hemiatrophy; Headache; Herpes Zoster Oticus; Humans; Male; Tinnitus

A 66-year-old woman was admitted to our hospital because of hoarseness and dysphagia after right earache and pharyngalgia. She showed right glossopharyngeal nerve and vagus nerve palsies, but no other neurological deficits. There was no skin rash within the regions of her ear, oral cavity, pharynx and larynx. Slight increase of mononuclear cells was noted in the cerebrospinal fluid. MR brain imaging was normal. We diagnosed her as zoster sine herpete (ZSH) and treated her with acyclovir, after which she almost completely recovered. The examination of antibodies and DNA of varicella zoster virus (VZV) in the serum and cerebrospinal fluid revealed a pattern of previous zoster infection without evidences of reactivation. However, VZV DNA was detected in auricular skin exudates with PCR. We conclude that PCR analysis of VZV DNA in auricular skin exudates can be a useful diagnostic tool for the diagnosis of zoster sine herpete presenting with painful glossopharyngeal nerve and vagus nerve palsies.

Topics: Acyclovir; Aged; Antiviral Agents; Deglutition Disorders; DNA, Viral; Ear; Earache; Exudates and Transudates; Female; Glossopharyngeal Nerve Diseases; Herpesvirus 3, Human; Humans; Polymerase Chain Reaction; Skin; Treatment Outcome; Zoster Sine Herpete