Herpes zoster oticus-diagnosis and treatment

Four cases of Herpes Zoster Oticus (HZO) with facial paralysis are presented. HZO is a Herpes Zoster viral infection of the Geniculate Ganglion of the facial nerve. It presents classically with severe otalgia, a vesicular rash in the Concha or on the Pinna of the affected ear in association with a lower motor neurone lesion of the homolateral facial nerve. There also may be labyrinthine symptoms, sensineural hearing loss and vesicular eruptions in the regions supplied by the vagus and glossopharyngeal nerves viz, hypopharynx and oropharynx as these nerves communicate with the facial nerve. Treatment consists of Acyclovir. One reference in the past refers to a clustering of the condition and its predisposition for females. Interestingly all cases presented were referred with incorrect diagnoses.