eMedicine Specialties > Emergency Medicine > Infectious Diseases
Herpes Zoster Oticus: Differential Diagnoses & Workup
Updated: Nov 4, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
| Bell Palsy | Otitis Externa |
| Headache, Cluster | Otitis Media |
| Headache, Migraine | Stroke, Hemorrhagic |
| Headache, Tension | Stroke, Ischemic |
| Herpes Zoster |
Other Problems to Be Considered
Isolated facial nerve trauma
Workup
Laboratory Studies
- Herpes zoster oticus is primarily a clinical diagnosis in the ED.
- Prior to initiating treatment with acyclovir, consider a baseline set of the following laboratory studies:
- Blood urea nitrogen (BUN)
- Creatinine
- Blood cell counts
- Electrolytes
Imaging Studies
- If diagnosis of Ramsay Hunt syndrome is not established by physical examination alone, consider a head CT scan to investigate other etiologies of facial paralysis.
More on Herpes Zoster Oticus |
| Overview: Herpes Zoster Oticus |
Differential Diagnoses & Workup: Herpes Zoster Oticus |
| Treatment & Medication: Herpes Zoster Oticus |
| Follow-up: Herpes Zoster Oticus |
| References |
| « Previous Page | Next Page » |
References
Furuta Y, Ohtani F, Mesuda Y. Early diagnosis of zoster sine herpete and antiviral therapy for the treatment of facial palsy. Neurology. Sep 12 2000;55(5):708-10. [Medline].
Murakami S, Honda N, Mizobuchi M. Rapid diagnosis of varicella zoster virus infection in acute facial palsy. Neurology. Oct 1998;51(4):1202-5. [Medline].
Whitley RJ, Weiss H, Gnann JW. Acyclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Ann Intern Med. Sep 1 1996;125(5):376-83. [Medline].
Wood MJ, Johnson RW, McKendrick MW, Taylor J, Mandal BK, Crooks J. A randomized trial of acyclovir for 7 days or 21 days with and without prednisolone for treatment of acute herpes zoster. N Engl J Med. Mar 31 1994;330(13):896-900. [Medline].
Uscategui T, Doree C, Chamberlain IJ, Burton MJ. Corticosteroids as adjuvant to antiviral treatment in Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev. Jul 16 2008;CD006852. [Medline].
Benson CA, Kaplan JE, Masur H. Treating opportunistic infections among HIV-exposed and infected children: recommendations from CDC, the National Institutes of Health, and the Infectious Diseases Society of America. MMWR Recomm Rep. Dec 17 2004;53(RR-15):1-112. [Medline].
Pavan-Langston D. Herpes zoster antivirals and pain management. Ophthalmology. Feb 2008;115(2 Suppl):S13-20. [Medline].
Harpaz R, Ortega-Sanchez IR, Seward JF. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. Jun 6 2008;57:1-30; quiz CE2-4. [Medline].
Adour KK. Otological complications of herpes zoster. Ann Neurol. 1994;35 Suppl:S62-4. [Medline].
Bauer CA, Coker NJ. Update on facial nerve disorders. Otolaryngol Clin North Am. Jun 1996;29(3):445-54. [Medline].
Murakami S, Hato N, Horiuchi J. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Ann Neurol. Mar 1997;41(3):353-7. [Medline].
Sweeney CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry. Aug 2001;71(2):149-54. [Medline].
Further Reading
Keywords
herpes zoster oticus, HZ oticus, viral infection of the ear, Ramsay Hunt syndrome, facial paralysis, varicella-zoster virus, VZV, reactivation of varicella-zoster virus, reactivation of VZV, postherpetic neuralgia, otalgia, hearing loss, vertigo
Differential Diagnoses & Workup: Herpes Zoster Oticus