Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults

Abstract

We found no evidence that anti-viral agents have a beneficial effect on outcomes in Ramsay Hunt syndrome, despite their widespread use in this condition. The use of these drugs in patients with herpes zoster infections in other parts of the body might suggest that they have a role in herpes zoster oticus. As usual, the absence of positive evidence of benefit (or, in this case, the 'negative' result of one small, statistically under-powered study) does not necessarily indicate that antivirals are ineffective. However, these drugs are associated with a number of adverse effects and this must be taken into consideration when undertaking the requisite risk-benefit analysis before instigating treatment.

Herpes zoster - is there a need for new treatment recommendations?

“…The frequency of herpes zoster oticus was less than expected in our study 9 . Cases of HZ associated with neuroinfection were also rare, due to the fact that these patients required a treatment by the intensive care specialists and were treated in the ICU ward of our clinic 14,29 .…”

Herpes zoster - is there a need for new treatment recommendations?

“…The frequency of herpes zoster oticus was less than expected in our study 9 . Cases of HZ associated with neuroinfection were also rare, due to the fact that these patients required a treatment by the intensive care specialists and were treated in the ICU ward of our clinic 14,29 .…”

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

“…However, a Cochrane review published in 2008 reported no evidence that supported the use of anti-viral agents, such as those widely used for other herpes zoster infections in other parts of the body. 17 …”

Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and prognosis

“…Uscategui et al demonstrated a statistically significant difference between combined acyclovir-corticosteroid therapy and treatment with corticosteroids alone. [7] Similarly, Kinishi et al reported that median recovery rate from facial palsy was 62% in patients treated with corticosteroids alone, however, with both acyclovir and steroid therapy, the receive rate was 90 percent. [6] The recovery rate was 84% in the study by Lee et al [8] In our study, we treated our patients with combined therapy and the overall recovery rate was 75 percent.…”

Herpes zoster - is there a need for new treatment recommendations?

“…The frequency of herpes zoster oticus was less than expected in our study 9 . Cases of HZ associated with neuroinfection were also rare, due to the fact that these patients required a treatment by the intensive care specialists and were treated in the ICU ward of our clinic 14,29 .…”

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

“…However, a Cochrane review published in 2008 reported no evidence that supported the use of anti-viral agents, such as those widely used for other herpes zoster infections in other parts of the body. 17 …”

Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and prognosis

“…Uscategui et al demonstrated a statistically significant difference between combined acyclovir-corticosteroid therapy and treatment with corticosteroids alone. [7] Similarly, Kinishi et al reported that median recovery rate from facial palsy was 62% in patients treated with corticosteroids alone, however, with both acyclovir and steroid therapy, the receive rate was 90 percent. [6] The recovery rate was 84% in the study by Lee et al [8] In our study, we treated our patients with combined therapy and the overall recovery rate was 75 percent.…”

Herpes zoster - is there a need for new treatment recommendations?

“…The frequency of herpes zoster oticus was less than expected in our study 9 . Cases of HZ associated with neuroinfection were also rare, due to the fact that these patients required a treatment by the intensive care specialists and were treated in the ICU ward of our clinic 14,29 .…”

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

“…However, a Cochrane review published in 2008 reported no evidence that supported the use of anti-viral agents, such as those widely used for other herpes zoster infections in other parts of the body. 17 …”

Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and prognosis

“…Uscategui et al demonstrated a statistically significant difference between combined acyclovir-corticosteroid therapy and treatment with corticosteroids alone. [7] Similarly, Kinishi et al reported that median recovery rate from facial palsy was 62% in patients treated with corticosteroids alone, however, with both acyclovir and steroid therapy, the receive rate was 90 percent. [6] The recovery rate was 84% in the study by Lee et al [8] In our study, we treated our patients with combined therapy and the overall recovery rate was 75 percent.…”