acyclovir and Parkinsonian-Disorders

Bell palsy is largely a diagnosis of exclusion, but certain features in the history and physical examination help distinguish it from facial paralysis due to other conditions: eg, abrupt onset with complete, unilateral facial weakness at 24 to 72 hours, and, on the affected side, numbness or pain around the ear, a reduction in taste, and hypersensitivity to sounds. Corticosteroids and antivirals given within 10 days of onset have been shown to help. But Bell palsy resolves spontaneously without treatment in most patients within 6 months.

Topics: Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Bell Palsy; Diagnosis, Differential; Humans; Parkinsonian Disorders; Practice Guidelines as Topic

Ramsay Hunt syndrome is an herpetic disease with ominous prognosis regarding the facial nerve. Treatment with acyclovir, a well-known virostatic agent, has been given in a small number of patients in recent years with excellent results. We report on the administration of acyclovir intravenously for 7 days in 31 patients with Ramsay Hunt syndrome, with overall recovery rate of 82.6%. There were no side effects regarding this treatment.

Topics: Acyclovir; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Antiviral Agents; Child; Drug Therapy, Combination; Facial Nerve; Female; Herpes Zoster; Humans; Hydrocortisone; Male; Middle Aged; Parkinsonian Disorders; Retrospective Studies; Severity of Illness Index

Topics: Acyclovir; Benserazide; Drug Combinations; Drug Therapy, Combination; Encephalitis, Viral; Female; Humans; Levodopa; Magnetic Resonance Imaging; Parkinsonian Disorders; Substantia Nigra; Young Adult

Ramsay-Hunt syndrome (RHS) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus (VZV) infection occurs in the geniculate ganglion. Major clinical findings are peripheral facial nerve palsy accompanied by ipsilateral ear pain and erythematous vesicular rash on the external ear (herpes zoster oticus) and in the mouth. Thus, diagnosis of RHS is usually clinical. However, auricular herpetic eruption is not always present, making diagnosis more difficult. This report describes a case of RHS with left facial palsy without skin lesions in 60-year-old woman. Multiple ulcers were found on her left soft palate. Polymerase chain reaction analysis on oral mucosa biopsy samples and serologic assays allowed the identification of VZV as the causal agent. Knowledge of the anatomy of the facial nerve is important for oral and maxillofacial surgeons when dealing with patients with RHS, especially in unusual and clinically misleading forms of this syndrome.

Topics: Acute Disease; Acyclovir; Antiviral Agents; Female; Glucocorticoids; Herpesvirus 3, Human; Humans; Middle Aged; Oral Ulcer; Palate, Soft; Parkinsonian Disorders; Prednisolone; Valacyclovir; Valine

We report a case of subacute-onset isolated parkinsonian syndrome in a 16 years old patient. Epstein-Barr infection was diagnosed according to serologic evidences. Parkinson-like syndrome completely recovered after 60 days. Autoantibodies reacting against a 130 Kda antigens expressed in human neuroblastoma cell line were detected. Pathogenesis and differential diagnosis are briefly discussed. EBV testing could be worthwhile in juvenile, acute-onset, parkinsonism.

Topics: Acute Disease; Acyclovir; Adolescent; Antiviral Agents; Autoantibodies; Blotting, Western; Cell Line, Tumor; Encephalitis, Viral; Epstein-Barr Virus Infections; Humans; Male; Neuroblastoma; Neurons; Parkinsonian Disorders