[Herpes zoster oticus: symptom constellation and serological diagnosis]

Herpes zoster oticus is a rare illness with cutaneous symptoms (eruptions) and a colored picture of brain nerve failures. The clinical symptoms, the symptom constellation, diagnostics and therapy, however, have been examined till now only in few studies.

In this study 91 cases of a zoster oticus were looked at in retrospect from the complete archives of the university ENT clinic Jena/Germany in the period from 1932 to 2001. Inclusion criterion was the occurrence eruptions in the ear region. The demographic data, subjective and objective symptoms, the symptom constellations, diagnostic methods and the therapy were arranged.

Women (68.1 %) were concerned more frequently than men (31.9 %). The average illness age was 51.2 days. The prodromal stage lasted for 2.2 days in the average. Earache (50.2 %) and headache (11.0 %) were the most frequent first symptoms. No prodroma appeared in 27.5 % of the cases. The facial nerve (86.8 %) was most frequently affected, the vestibular nerve in 76.9 % and the cochlear nerve in 36.3 %. Other brain nerve damages were extremly rare. The therapy success was identical with regard to the brain nerve regeneration at all times. A positive antibody titer for VZV-IgM and/or IgA or an IgG is a sign for an acute infektion. VZV-IgA antibody titers appeared more constantly, frequent and early than an IgM.

Women have a greater risk of falling ill at a zoster oticus than men. Although more than 72 hours is behind the beginning of the symptoms in this study, treatment with virostatic drugs should always be carried out in zoster oticus. Different therapy methods do not have any influence to the success therapy of the therapy. The facial nerve showed the best cure trend. A postzosteric pain develops approximately the half of the cases at the zoster oticus. The serological diagnostic is not necessary in clinically clear cases.