eMedicine Specialties > Emergency Medicine > Infectious Diseases
Herpes Zoster Oticus: Follow-up
Updated: Nov 4, 2008
Follow-up
Further Inpatient Care
- For patients with herpes zoster oticus, consider admission for any of the following situations:
- Severe symptoms
- Involvement of multiple (>2) dermatomes
- Immunocompromise
Further Outpatient Care
- Ensure that the patient has adequate and timely outpatient follow-up for management of HZ oticus.
- Consultation with an ear, nose, and throat (ENT) specialist may be appropriate.
Complications
Complications of herpes zoster oticus may include the following:
- Postherpetic neuralgia
- Residual paralysis
Prognosis
- Prolonged or permanent facial paralysis (possible)
- Most patients with partial paralysis fully recover; many with severe symptoms are left with partial deficits.
Patient Education
- Instruct patients how to tape eyes shut if lid paralysis is present.
Miscellaneous
Medicolegal Pitfalls
- Failure to recognize a central cause of facial paralysis
- Failure to recognize and treat ocular complications
- Failure to identify immunoincompetence
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 |
References
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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
Follow-up: Herpes Zoster Oticus