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Published on: April 2, 2012
Zoster sine herpete causing facial palsy
Ho Yun Lee1, Myung Gu Kim, Dong Choon Park
1Department of Otolaryngology, College of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, Korea.
American Journal of Otolaryngology
|March 27, 2012
Summary
Zoster sine herpete (ZSH) facial palsy shows slower recovery, especially with pain. Combination therapy with steroids and antivirals is more effective than steroids alone for ZSH patients. Pain presence aids ZSH diagnosis.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Zoster sine herpete (ZSH) is a variant of herpes zoster ophthalmicus causing facial palsy without a rash.
- Differentiating ZSH from other causes of facial palsy, such as Bell palsy and Ramsay Hunt syndrome, is crucial for appropriate management.
- Understanding the treatment efficacy and recovery patterns in ZSH is essential for improving patient outcomes.
Purpose of the Study:
- To characterize zoster sine herpete (ZSH) causing facial palsy.
- To evaluate the effectiveness of different treatment regimens for ZSH.
- To distinguish ZSH from other facial palsy etiologies.
Main Methods:
- A prospective study of 45 patients with ZSH facial palsy from March 2010 to March 2011.
- Patients were assigned to either steroid treatment or a steroid-antiviral combination therapy group.
- Retrospective comparison with Bell palsy and Ramsay Hunt syndrome cases diagnosed during the same period.
Main Results:
- No significant improvement was noted in the overall ZSH group within 3 weeks, irrespective of treatment.
- ZSH patients with accompanying pain showed significant continuous improvement after 6 weeks with combination therapy.
- ZSH with pain had a significantly different recovery rate compared to Bell palsy (89.9% recovery).
Conclusions:
- Recovery onset in ZSH is delayed compared to other peripheral palsies.
- ZSH with pain exhibits slower recovery than Bell palsy.
- Steroid-antiviral combination therapy is superior to steroid-only treatment for ZSH; identifying pain is key for diagnosis.
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