Treatment of ramsay hunt syndrome with acyclovir‐prednisone: Significance of early diagnosis and treatment

  title={Treatment of ramsay hunt syndrome with acyclovir‐prednisone: Significance of early diagnosis and treatment},
  author={Shingo Murakami and Naohito Hato and Joji Horiuchi and Nobumitsu Honda and Kiyofumi Gyo and Naoaki Yanagihara},
  journal={Annals of Neurology},
Although the antiviral agent acyclovir is currently used for the treatment of Ramsay Hunt syndrome, its effects on facial nerve and hearing recovery remain controversial. We retrospectively analyzed the effects of acyclovir‐prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days… 

Acyclovir improves recovery rate of facial nerve palsy in Ramsay Hunt syndrome.

Ramsay Hunt Syndrome in Two Children: Case Report

The aim of this case report is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of Ramsay Hunt syndrome.

Comparison of Acyclovir and Famciclovir for Ramsay Hunt Syndrome.

Recovery rates in patients with RHS were higher following treatment with steroids plus famciclovir than with steroid plus acyclovir, especially in patients without hypertension and diabetes mellitus.

[Treatment of Bell's palsy with acyclovir and prednisolone].

Early treatment, within 3 days after palsy onset, is necessary for effective acyclovir-prednisolone therapy of Bell's palsy, and this early treatment was highly efficacious in the prevention of nerve degeneration and resulted in a significantly better recovery.

Ramsay Hunt Syndrome Treated with Oral Acyclovir.

Prognostic Factors in Herpes Zoster Oticus (Ramsay Hunt Syndrome)

  • S. CoulsonG. CroxsonR. AdamsVictoria Oey
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2011
All patients with HZO improved facial function to some degree, with the mean gain at 1 year after onset being 3 HB grade units, but improvement was less for patients who initially had both incomplete eye closure and dry eye.

Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults.

No evidence is found that anti-viral agents have a beneficial effect on outcomes in Ramsay Hunt syndrome, despite their widespread use in this condition.

Ramsay Hunt Syndrome – A Diagnostic Dilemma

Due to the anti-inflammatory effect of steroids, an enhanced recovery can be achieved in patients with steroid treatment in Bell palsy and Ramsay Hunt syndrome, and the treatment for patients with Ramsay Hunt with antiviral agents may prevent disease progression and improve prognosis by inhibiting the spread of herpes zoster virus.

Acyclovir in the Treatment of Ramsay Hunt Syndrome


Effect of acyclovir in Ramsay Hunt syndrome.

In the present study, the effect of acyclovir on the prognosis of facial paralysis of Ramsay Hunt syndrome was relatively favorable.

Herpes zoster oticus: Treatment with intravenous acyclovir

Five of the seven patients treated for zoster showed some return of facial function at the time of discharge, and at follow-up, 4 patients had achieved a House grade I result, 1 patient a grade II, and 2 patients a grade III.

Ramsay Hunt Facial Paralysis: Clinical Analyses of 185 Patients

The facial palsy of Ramsay Hunt syndrome was found to be more severe, to cause late neural denervation, and to have a less favorable recovery profile than Bell's (herpes simplex) facial palsies.

[Conservative treatment of Hunt syndrome].

Oral steroids are best used in cases of incomplete palsy unless complete palsy develops, and it is now believed that SD therapy should be started immediately.

The use of Acyclovir in Ramsay Hunt Syndrome

Acyclovir is a specific anti-viral agent which has been used in the treatment of the Ramsay Hunt Syndrome with encouraging results, and no previous study has been published utilizing this treatment.

The natural history of facial paralysis in herpes zoster.

A group of 102 patients with facial palsy caused by herpes zoster was studied in order to determine the course and prognosis without treatment and recovery was better when the vesicles preceded complete loss of function.

Otological complications of herpes zoster

Gadolinium‐enhanced magnetic resonance imaging demonstrates enhancement of the geniculate ganglion and facial nerve in varicella‐zoster virus (Ramsay Hunt syndrome), which is identical to Bell's palsy but is more severe and carry a graver prognosis.

Audiological manifestations of Ramsay Hunt syndrome

A retrospective review of the audiological manifestations of 186 patients with Ramsay Hunt syndrome, measuring their hearing loss patterns, hyperacusis, tinnitus, herpetic rash, facial paralysis, pain and vertigo, found prognosis for eventual hearing recovery is, in general, excellent.

Varicella-Zoster Virus

It was found that serological testing of paired sera was necessary to differentiate idiopathic Bell's palsy from Ramsay-Hunt's syndrome and complement fixing antibody titers to varicella-zoster and herpes simplex virus were determined in association with the inflammatory findings in the increased antibody group.

Herpes Zoster Oticus: Treatment with Acyclovir

Acyclovir, a specific virostatic drug, was given intravenously in five herpes zoster oticus patients, and in three of them was followed by oral therapy, and good results encourage the use of acyclovir in herpesZoster oicus patients.