Jure Pupić-Bakrač1, Ana Pupić-Bakrač2, Vedrana Terkeš3, Ivan Baraka4. 1. Department of Otorhinolaryngology and Maxillofacial Surgery, General Hospital Zadar, Bože Peričića 5, 23 000, Zadar, Croatia. jureppbkr2@gmail.com. 2. Department of Ophthalmology, General Hospital Zadar, Bože Peričića 5, 23 000, Zadar, Croatia. 3. Department of Infectology, General Hospital Zadar, Bože Peričića 5, 23 000, Zadar, Croatia. 4. Department of Otorhinolaryngology and Maxillofacial Surgery, General Hospital Zadar, Bože Peričića 5, 23 000, Zadar, Croatia.
Abstract
PURPOSE: Cranial polyneuropathy (CP) is a rare complication of herpes zoster (HZ) infection. This entity often produces situations of a diagnostic dilemma, as can be seen in a wide spectrum of clinical presentations. The aim of this study was to report the clinical characteristics, treatment, and outcomes of 11 patients from a single-institution experience. METHODS: A retrospective analysis of patients treated for HZ CP over a 12-year period was performed. RESULTS: The present study included 11 patients with CP caused by HZ infection-7 (63.63%) females, and 4 (36.36%) males. The mean age at presentation was 63 years (range, 38-85 years). Cranial nerve VII was affected in nine (81.82%) cases, CN VIII in six (54.55%) cases, CN V in five (45.45%) cases, CN III and IX in two (18.18%) cases, and CN VI and X in one (9.09%) case. The treatment of choice was acyclovir in all patients, while corticosteroids were administered in six (54.55%) patients. Complete CN recovery was observed in seven (63.63%) patients, while four (36.36%) patients suffered from permanent CN damage-two (18.18%) CN VII, one (9.09%) CN VII and VIII, and one (9.09%) CN VI. CONCLUSION: Herpes zoster CP presents an interesting diagnostic and therapeutic challenge. Successful management of these patients depends on a thorough knowledge of the anatomy and topodiagnostic of CNs. Early administration of antiviral agents is crucial in terms of responsiveness to treatment and expedite recovery.
PURPOSE: Cranial polyneuropathy (CP) is a rare complication of herpes zoster (HZ) infection. This entity often produces situations of a diagnostic dilemma, as can be seen in a wide spectrum of clinical presentations. The aim of this study was to report the clinical characteristics, treatment, and outcomes of 11 patients from a single-institution experience. METHODS: A retrospective analysis of patients treated for HZ CP over a 12-year period was performed. RESULTS: The present study included 11 patients with CP caused by HZ infection-7 (63.63%) females, and 4 (36.36%) males. The mean age at presentation was 63 years (range, 38-85 years). Cranial nerve VII was affected in nine (81.82%) cases, CN VIII in six (54.55%) cases, CN V in five (45.45%) cases, CN III and IX in two (18.18%) cases, and CN VI and X in one (9.09%) case. The treatment of choice was acyclovir in all patients, while corticosteroids were administered in six (54.55%) patients. Complete CN recovery was observed in seven (63.63%) patients, while four (36.36%) patients suffered from permanent CN damage-two (18.18%) CN VII, one (9.09%) CN VII and VIII, and one (9.09%) CN VI. CONCLUSION: Herpes zoster CP presents an interesting diagnostic and therapeutic challenge. Successful management of these patients depends on a thorough knowledge of the anatomy and topodiagnostic of CNs. Early administration of antiviral agents is crucial in terms of responsiveness to treatment and expedite recovery.
Authors: R Zainine; M Sellami; A Charfeddine; N Beltaief; S Sahtout; G Besbes Journal: Eur Ann Otorhinolaryngol Head Neck Dis Date: 2012-02-24 Impact factor: 2.080