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Čelakovská J, Boudková P, Wertzova V, Čáková L. Ramsay Hunt syndrome in atopic dermatitis patient treated with dupilumab. Int Immunopharmacol 2024; 136:112345. [PMID: 38820959 DOI: 10.1016/j.intimp.2024.112345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024]
Abstract
The Ramsay-Hunt syndrome results from reactivation of the varicella-zoster virus at the geniculate ganglion level. The syndrome is characterized by a combination of symptoms such as ipsilateral facial paralysis, otalgia, and vesicles near the ear and auditory canal. The gold standard in the treatment of Ramsay-Hunt syndrome remains the combination of antiviral therapy with corticosteroids and adequate analgesic therapy. We present a case of a 45-year-old patient with severe form of atopic dermatitis, who developed this syndrome during treatment with dupilumab. The risks and benefits of dupilumab treatment in this patient were considered. Because both bronchial asthma and atopic dermatitis worsened when dupilumab was discontinued, it was indicated to continue this therapy with low-dose of acyclovir.
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Affiliation(s)
- Jarmila Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové 50002, Czech Republic.
| | - Petra Boudková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové 50002, Czech Republic
| | - Veronika Wertzova
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové 50002, Czech Republic
| | - Lenka Čáková
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové 50002, Czech Republic
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Badur S, Senol E, Azap A, Yesiloglu C, Ozakay A, Ozturk S, Guzman-Holst A. Herpes Zoster Burden of Disease and Clinical Management in Turkey: A Comprehensive Literature Review. Infect Dis Ther 2023; 12:1937-1954. [PMID: 37530949 PMCID: PMC10505134 DOI: 10.1007/s40121-023-00849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Herpes zoster (HZ), or shingles, is caused by the reactivation of varicella zoster virus (VZV) and typically presents as an acute, painful dermatomal rash, but can lead to long-term, distressing complications such as postherpetic neuralgia (PHN). Increasing trends in HZ cases are evident globally among the aging population; however, reviews investigating the epidemiology and clinical management of HZ in Turkey are lacking. Therefore, a literature review of local studies in Turkey was conducted to identify the data available and identify gaps in the literature. METHODS Literature searches were carried out in PubMed and local journals to retrieve published articles that reported surveillance data, seroepidemiology, patient outcomes, or clinical management related to HZ or VZV in Turkey until April 30, 2022. Studies included primary data reports, case studies, secondary data reviews, and epidemiological studies in healthy or at-risk populations; HZ was the primary focus of the review. RESULTS No studies reported VZV or HZ epidemiological data at a national level. One large retrospective study in Istanbul reported that HZ incidence rates significantly increased in adults 18-44 years of age between 2011 and 2019. Four single-center studies reported the proportion of dermatological patients with HZ at 0.43-1.56%. PHN was the most common reported complication, occurring in 8-58.9% of patients with HZ. However, out of 39 identified case reports, HZ ophthalmicus was the most frequently reported complication. Two studies highlighted poor disease awareness and risk perception of HZ among Turkish citizens. CONCLUSION Overall, there were limited comprehensive epidemiological data on HZ in Turkey. However, the abundance of case studies on HZ complications indicates a strong disease presence and diverse clinical management in Turkey. Further research will be important to understand the impact of HZ, increase disease awareness, and support the introduction of new preventative strategies.
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Halliday E, Wooles N, Grainger J. Fifteen-minute consultation: A structured approach to the assessment of a child with earache. Arch Dis Child Educ Pract Ed 2023; 108:2-9. [PMID: 34580153 DOI: 10.1136/archdischild-2021-322697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/06/2021] [Indexed: 02/05/2023]
Abstract
Earache, or otalgia, in children is common. Diagnosis can be challenging due to the range of causes. Assessment involves a thorough history and examination. Identification of associated otological symptoms, including discharge, hearing loss, vertigo and facial nerve weakness, is helpful and can aid diagnosis. Examination should involve looking at the external ear, otoscopy to assess the ear canal and tympanic membrane and documentation of facial nerve function. If otological examination is normal, further examination looking for non-otological causes may be guided by the history. Investigations are often unnecessary but may include blood tests, audiology and imaging. Most otalgia is caused by an acute infection, which is self-limiting and can be managed in the community. However, ear, nose and throat (ENT) advice and input may be required for systemically unwell children or those who fail to improve despite appropriate medical therapy.
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Affiliation(s)
- Edwin Halliday
- Department of Otolaryngology/Head & Neck Surgery, Birmingham Children's Hospital, Birmingham, UK
| | - Nicola Wooles
- Department of Otolaryngology/Head & Neck Surgery, Birmingham Children's Hospital, Birmingham, UK
| | - Joe Grainger
- Department of Otolaryngology/Head & Neck Surgery, Birmingham Children's Hospital, Birmingham, UK
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Bobinger-Girke B, Steidl M, Schnelke A. [Peripheral facial nerve palsy and blisters on the ear after a vaccination]. Monatsschr Kinderheilkd 2022; 172:1-4. [PMID: 36249545 PMCID: PMC9552165 DOI: 10.1007/s00112-022-01616-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Bettina Bobinger-Girke
- Klinikum Landsberg am Lech, Bürgermeister-Dr.-Hartmann-Str. 50, 86899 Landsberg am Lech, Deutschland
| | - Michael Steidl
- Klinikum Landsberg am Lech, Bürgermeister-Dr.-Hartmann-Str. 50, 86899 Landsberg am Lech, Deutschland
| | - Alexander Schnelke
- Klinikum Landsberg am Lech, Bürgermeister-Dr.-Hartmann-Str. 50, 86899 Landsberg am Lech, Deutschland
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Abstract
Otalgia can be broadly categorized into primary otologic causes and secondary nonotologic causes. Isolated otalgia in the absence of hearing loss, otorrhea, or abnormal otoscopic findings is typically secondary to referred pain from nonotologic causes, as the sensory nerve supply to the ear arises from 4 cranial nerves and the cervical plexus. The most common causes of primary otalgia are acute otitis media and otitis externa, whereas the most common causes of secondary otalgia are temporomandibular joint disorders and dental pathology. Persistent unilateral ear pain and other alarm symptoms warrant further evaluation for possible neoplasm.
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Affiliation(s)
- Tiffany Peng Hwa
- Department of Otolaryngology/Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Silverstein 5, Philadelphia, PA 19103, USA
| | - Jason A Brant
- Department of Otolaryngology/Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Silverstein 5, Philadelphia, PA 19103, USA.
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Silva MR, Leite L, Sousa FP, Maré R, Pontes T. Ramsay Hunt's Syndrome in Pediatric Age. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0040-1722618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractThe Ramsay Hunt's syndrome (RHS), caused by the reactivation of the varicella-zoster virus (VZV), is an infrequent cause of peripheral facial palsy in the pediatric patients. A 16-year-old adolescent boy presented with headache, right earache, and signs of lower motor neuron type facial palsy. He was medicated with deflazacort. Four days later, he developed blurry vision in the right eye, gait imbalance, and vesicular lesions in the right ear with decreased ipsilateral hearing acuity. A diagnosis of RHS was considered. Cerebrospinal fluid (CSF) analysis showed pleocytosis, as well as VZV DNA. Magnetic resonance imaging of the brain identified abnormal uptake of gadolinium contrast in the right seventh cranial nerve, reinforcing the diagnosis. The patient was treated with acyclovir (14 days) and prednisone, with progressive clinical improvement. We emphasize the importance of recognizing this syndrome in patients with facial palsy, since the early antiviral treatment significantly improves the prognosis.
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Affiliation(s)
| | - Lídia Leite
- Department of Pediatric Department, Hospital de Braga, Braga, Portugal
| | | | - Ricardo Maré
- Department of Neurology Department, Hospital de Braga, Braga, Portugal
| | - Teresa Pontes
- Department of Pediatric Department, Hospital de Braga, Braga, Portugal
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Guess KE, Harada Y, Hill A, Ferry J, Veerapandiyan A. A Toddler With Bilateral Facial Weakness. Clin Pediatr (Phila) 2020; 59:529-531. [PMID: 31948285 DOI: 10.1177/0009922819901007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Katherine E Guess
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yohei Harada
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aubrey Hill
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer Ferry
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aravindhan Veerapandiyan
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Ramirez-Salas JE, Benito-Orejas JI, Bauer M, Viveros-Díez P, Cifuentes-Navas VA, Duque-Holguera V. Manifestaciones clínicas del síndrome de Ramsay-Hunt en una serie de 20 casos. REVISTA ORL 2020. [DOI: 10.14201/orl.22750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: la experiencia clínica nos ha mostrado las distintas formas de presentación y la variabilidad sintomatológica que puede revelar el síndrome de Ramsay-Hunt o herpes zóster ótico. Las descripciones que ofrece la literatura nos han servido para corroborar los hallazgos de un conjunto de pacientes, cuyas características y evolución hemos ido reuniendo en el tiempo. Dada la importancia del tratamiento precoz, el objetivo de este trabajo ha consistido en realizar una exposición estructurada de este complejo síndrome con sus diversas manifestaciones. Método: estudio retrospectivo. Resultados: 20 pacientes ejemplifican los diferentes aspectos de este proceso. Discusión: se trata de una patología infrecuente, con una tríada sintomática patognomónica que consiste en otalgia, erupción vesicular y parálisis facial. Sin embargo, este síndrome no siempre se expresa de forma completa ni con la aparición de los síntomas en el orden indicado, añadiéndose con frecuencia otros cocleovestibulares. La posibilidad de que la infección se propague de forma centrífuga y centrípeta facilita el que se afecten otros nervios sensitivos y motores, ocasionando una polineuropatía craneal (herpes zóster cefálico) y raquídea o incluso, con mucha menor frecuencia, la aparición de una meningoencefalitis. No conocemos con precisión los mecanismos por los que progresa este proceso ni los factores desencadenantes, aunque en ocasiones les haya predisponentes. Establecer un diagnóstico es fundamental para iniciar el tratamiento, cuya precocidad facilita la resolución del proceso. Conclusiones: siendo la sospecha clínica la principal herramienta de un diagnóstico precoz, nos ha parecido de interés realizar esta revisión, dada la infrecuencia del herpes zóster ótico.
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Growth dynamic of the geniculate ganglion in children: a retrospective computed tomography study. Surg Radiol Anat 2019; 42:307-314. [DOI: 10.1007/s00276-019-02386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
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Hamzaoğlu V, Beger O, Erdoğan O, Kara E, Vayisoğlu Y, Taghipour P, Özalp H, Karataş D, Avcı E, Dağtekin A, Bağdatoğlu C, Öztürk AH, Talas DÜ. Radioanatomic Assessment of the Geniculate Ganglion Dehiscence and Dimension: A Cadaveric Study. World Neurosurg 2019; 134:e913-e919. [PMID: 31733393 DOI: 10.1016/j.wneu.2019.11.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The main aim of this study placed on cadavers was to compare the data related to geniculate ganglion (GG) dehiscence and dimension obtained from computed tomography (CT) with dissection values. METHODS This study was conducted on 20 temporal bones obtained from 10 cadavers (4 female, 6 male) aged between 45 and 92 (71.50 ± 15.98) years. All the measurements related to GG dimension were performed with a CT scanner and microdissection. RESULTS The size of GG including its area, length, and width did not show statistically significant differences in terms of sex, side, and assessment method (CT and cadaveric dissections). The dehiscent GG was observed in 6 (30%) and 5 (25%) out of 20 temporal bones in CT and cadaveric dissections, respectively. The presence and absence of GG dehiscence in CT and dissection were similar in 75%. CONCLUSIONS Our findings based on dissection data suggest that radiologic evaluation of dehiscent GG detection might be erroneous by 25%, which highlights that surgeons should be careful when lifting the dura to prevent GG injury during middle cranial fossa surgical approaches. On the other hand, there was no statistical difference between CT and dissection measurements related to GG dimension.
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Affiliation(s)
- Vural Hamzaoğlu
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Orhan Beger
- Mersin University Faculty of Medicine, Department of Anatomy, Mersin, Turkey.
| | - Osman Erdoğan
- Şanlıurfa Training and Research Hospital, Department of Otorhinolaryngology, Şanlıurfa, Turkey
| | - Engin Kara
- Mersin University Faculty of Medicine, Department of Radiology, Mersin, Turkey
| | - Yusuf Vayisoğlu
- Mersin University Faculty of Medicine, Department of Otorhinolaryngology, Mersin, Turkey
| | | | - Hakan Özalp
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Derya Karataş
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Emel Avcı
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Ahmet Dağtekin
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Celal Bağdatoğlu
- Mersin University Faculty of Medicine, Department of Neurosurgery, Mersin, Turkey
| | - Ahmet Hakan Öztürk
- Mersin University Faculty of Medicine, Department of Anatomy, Mersin, Turkey
| | - Derya Ümit Talas
- Mersin University Faculty of Medicine, Department of Otorhinolaryngology, Mersin, Turkey
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Conversano E, Cozzi G, Poropat F, Di Mascio A, Salis S, Grasso DL, Barbi E. Adolescent with painful vesicular otitis and vertigo. Arch Dis Child Educ Pract Ed 2019; 104:103-105. [PMID: 29440126 DOI: 10.1136/archdischild-2017-313883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/02/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Ester Conversano
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Giorgio Cozzi
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Federico Poropat
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Alberto Di Mascio
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Simona Salis
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Domenico Leonardo Grasso
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
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12
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Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial nerve palsy in children: A retrospective study of 124 cases. J Paediatr Child Health 2019; 55:299-304. [PMID: 30144181 DOI: 10.1111/jpc.14190] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/13/2018] [Accepted: 07/22/2018] [Indexed: 11/30/2022]
Abstract
AIM To report the causes and clinical evaluation of children with facial nerve palsy (FNP) admitted to an affiliated university hospital during a 5-year period (2011-2015). METHODS A total of 124 children were retrospectively categorised into two groups: idiopathic Bell's palsy (109 patients) and the second group into other FNP aetiologies (15 patients). All children received a standardised work-up and follow-up. Therapy consisted of steroid administration associated with antiviral treatment when a viral infection was suspected. RESULTS All children of the first group had a full recovery under oral steroids within 2 months of treatment. From the second group, seven children (46%) had a viral infection based on serological findings, two of them were positive for neurotropic herpes viruses, and one had Ramsay Hunt syndrome; six children with infectious FNP had recurrent FNP on the ipsilateral or contralateral side. Five patients had FNP as a complication of acute otitis media; three of them (60%) had partial or full recovery postoperatively. One child developed FNP following temporal bone trauma that had an uneventful recovery with conservative treatment. One child suffered from Melkersson-Rosenthal syndrome, and another child presented with FNP associated with unilateral hemiparesis following an ischaemic cerebral infarct. CONCLUSIONS Facial palsy in children is a manifestation of a heterogeneous group of causes. The most common aetiology of FNP in children in our study was idiopathic (Bell's palsy), followed by infective causes, such as acute otitis media and neurotropic herpes viruses. Therefore, treatment should be adapted to each patient depending on the underlying disease and severity of FNP.
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Affiliation(s)
- George Psillas
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Elias Antoniades
- 1st Academic Neurosurgery Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Fotini Ieridou
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Al-Turab M, Chehadeh W. Varicella infection in the Middle East: Prevalence, complications, and vaccination. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:19. [PMID: 29887897 PMCID: PMC5961286 DOI: 10.4103/jrms.jrms_979_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/20/2017] [Accepted: 01/22/2018] [Indexed: 02/01/2023]
Abstract
Varicella (chickenpox) is the primary infection of varicella-zoster virus (VZV), it is a mild self-limiting infection, but it is also highly contagious and can cause severe complications among high-risk group of individuals. It is usually a childhood infection providing lifelong immunity, but adults without varicella history are also susceptible to infection. High-risk group of individuals is more likely to develop serious complications. Varicella vaccine was introduced to protect this group of individuals and to prevent epidemic spread of VZV infection in a community. Thus, it was added to the recommended vaccination schedules for children in most developed countries. This review aimed to outline varicella status, seroprevalence, complications, and vaccination in the Middle East region. Based on our findings, children were the most affected age group, but there are also adult cases due to high number of expatriates, especially in Gulf Cooperation Council countries. Central nervous system involvements and skin diseases followed by varicella pneumonia were the most varicella-associated complications. Varicella vaccine was introduced in most Middle East countries, either mandatory by the Ministries of Health or optional in the private clinics. Few numbers of studies have reported an obvious reduction in varicella prevalence, hospitalizations, and deaths in the Middle East following varicella vaccination. A basic database about varicella infection before the initiation and implementation of a vaccination policy is essential to determine the target group of individuals. As far as our knowledge, this is the first review about varicella infection in the Middle East.
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Affiliation(s)
- Mariam Al-Turab
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Wassim Chehadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
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Kim JM, Lee Z, Han S, Park D. Treatment of Ramsay-Hunt's syndrome with multiple cranial nerve involvement and severe dysphagia: A case report. Medicine (Baltimore) 2018; 97:e0591. [PMID: 29703055 PMCID: PMC5944505 DOI: 10.1097/md.0000000000010591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Ramsay-Hunt's syndrome (RHS) is a disorder characterized by facial paralysis, herpetic eruptions on the auricle, and otic pain due to the reactivation of latent varicella zoster virus in the geniculate ganglion. A few cases of multiple cranial nerve invasion including the vestibulocochlear nerve, glossopharyngeal nerve and vagus nerve have been reported. However, there has been no report about RHS with delayed onset multiple cranial nerve involvement causing severe aspiration, and a clinical course that improved after more than one year of dysphagia rehabilitation and percutaneous endoscopic gastrostomy (PEG). Here, we report on a 67-year old male with delayed onset swallowing difficulty after 16 days of RHS development. PATIENT CONCERN Severe aspiration during swallowing. DIAGNOSIS Severe dysphagia caused by RHS with multiple cranial nerve involvement. INTERVENTION Application of percutaneous endoscopic gastrostomy (PEG) and rehabilitation therapy of dysphagia. OUTCOMES After 13 months from symptom onset, his PAS improved from 7 to 2 in follow-up video-fluoroscopic swallowing study (VFSS). Then, he was re-admitted, and the PEG tube was removed and oral feeding was started. LESSONS This case gives us the lesson that optimal doses of acyclovir and corticosteroids are important to prevent progression of multiple cranial involvement in RHS, and swallowing difficulty in RHS patients with multiple cranial nerve involvement can be improved through long-term rehabilitation even if there is no improvement for more than one year.
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Affiliation(s)
- Jong Min Kim
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Zeeihn Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Seungwoo Han
- Division of Rheumatology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
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Chang DS, Lee J, Shin SA, Lee HY. Characteristics of patients with acute peripheral facial palsy showing
Varicella zoster virus
DNA in saliva. J Med Virol 2018; 90:959-964. [DOI: 10.1002/jmv.25030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 12/24/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Dong Sik Chang
- Department of OtorhinolaryngologyEulji University HospitalEulji UniversityDaejeonRepublic of Korea
| | - Jun Lee
- Department of OtorhinolaryngologyEulji University HospitalEulji UniversityDaejeonRepublic of Korea
| | - Sun Ae Shin
- Department of Medical ScienceChungnam National UniversityDaejeonKorea
| | - Ho Yun Lee
- Department of OtorhinolaryngologyEulji University HospitalEulji UniversityDaejeonRepublic of Korea
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Guerreschi P, Gabert PE, Labbé D, Martinot-Duquennoy V. [Facial palsy in children]. ANN CHIR PLAST ESTH 2016; 61:513-518. [PMID: 27637411 DOI: 10.1016/j.anplas.2016.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 07/19/2016] [Indexed: 11/25/2022]
Abstract
Facial palsy (FP) in children is congenital or acquired. When present at birth (congenital), etiologies are mostly traumatic and rarely developmental. Acquired FP needs investigation. Research on the etiology helps to determine prognostic and treatment. At most times, no specific cause is found. Treatment of idiopathic FP consists of early oral corticosteroid therapy and ocular protection. Treating the sequelae is essential and the physician has to consider the dynamic balance of both sides of the face. Dynamic rehabilitation should mainly concern the inferior facial third. We recommend the lengthening temporalis myoplasty (LTM). This relevant technique ensures replicable and reliable results with a harmonious smile. Facial dynamic rehabilitation after surgical procedure (muscle tranfer or free muscle flap) must be directed toward control of voluntary movement, to move from a mandibular smile to a spontaneous and voluntary smile, thanks to brain plasticity. Furthermore, botulinum toxin is well tolerated and remains a great tool to treat a child who can support injections.
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Affiliation(s)
- P Guerreschi
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France.
| | - P-E Gabert
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France
| | - D Labbé
- 4, place Fontette, 14000 Caen, France
| | - V Martinot-Duquennoy
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France
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Monsanto RDC, Bittencourt AG, Bobato Neto NJ, Beilke SCA, Lorenzetti FTM, Salomone R. Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature. Int Arch Otorhinolaryngol 2016; 20:394-400. [PMID: 27746846 PMCID: PMC5063726 DOI: 10.1055/s-0036-1584267] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/12/2016] [Indexed: 11/16/2022] Open
Abstract
Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction. Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature. Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4%) achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI), 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone. Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.
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Affiliation(s)
| | - Aline Gomes Bittencourt
- Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
- Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Natal José Bobato Neto
- Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
| | | | - Fabio Tadeu Moura Lorenzetti
- Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
- Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Raquel Salomone
- Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
- Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
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Ciorba A, Corazzi V, Conz V, Bianchini C, Aimoni C. Facial nerve paralysis in children. World J Clin Cases 2015; 3:973-979. [PMID: 26677445 PMCID: PMC4677084 DOI: 10.12998/wjcc.v3.i12.973] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/04/2015] [Accepted: 10/13/2015] [Indexed: 02/05/2023] Open
Abstract
Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.
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Pediatric Ramsay Hunt Syndrome: Analysis of Three Cases. Case Rep Otolaryngol 2015; 2015:971249. [PMID: 26435868 PMCID: PMC4575983 DOI: 10.1155/2015/971249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/01/2015] [Accepted: 08/19/2015] [Indexed: 11/17/2022] Open
Abstract
Ramsay Hunt syndrome (RHS) is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction and is attributed to varicella zoster virus (VZV) infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. The diagnosis is based on history and physical findings. Treatment of RHS uses a combination of high-dose corticosteroids and acyclovir. This paper presents three cases diagnosed as RHS in the pediatric age group in association with the literature review. The aim of this paper is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of RHS.
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Lehman H, Rushinek H. A rare case of Ramsay Hunt syndrome following temporomandibular joint surgery. Int J Oral Maxillofac Surg 2015; 44:1038-40. [PMID: 25864001 DOI: 10.1016/j.ijom.2015.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/12/2015] [Accepted: 03/25/2015] [Indexed: 11/16/2022]
Abstract
Surgical approaches to the temporomandibular joint (TMJ) have been designed specifically to minimize injury to the temporal branch of the facial nerve. In spite of this, facial nerve dysfunction occurs in 1-32% of patients undergoing TMJ surgery. Ramsay Hunt syndrome is characterized by peripheral facial paralysis that often involves other cranial nerves, mostly cranial nerve VIII. The pathology is attributed to the reactivation of latent varicella zoster virus in the geniculate ganglion. The diagnosis is based mostly on history and physical findings. Surgical procedures have been known to reactivate varicella zoster virus, but Ramsay Hunt syndrome subsequent to TMJ surgery has not been described yet. This report describes a case of Ramsay Hunt syndrome associated with TMJ surgery. Because of the relatively high incidence of facial nerve dysfunction associated with TMJ surgery, patients with varicella zoster virus reactivation may initially be misdiagnosed with iatrogenic facial palsy, or vice versa.
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Affiliation(s)
- H Lehman
- Division of Oral and Maxillofacial Surgery, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
| | - H Rushinek
- Department of Oral and Maxillofacial Surgery, Hadassah Faculty of Dental Medicine, The Hebrew University, Kiryat Hadassah, Jerusalem, Israel
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A pediatric case of ramsay hunt syndrome. Case Rep Otolaryngol 2014; 2014:469565. [PMID: 25276457 PMCID: PMC4172874 DOI: 10.1155/2014/469565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/21/2014] [Indexed: 01/08/2023] Open
Abstract
Ramsay Hunt syndrome (RHS) is characterized by facial paralysis, inner ear dysfunction, periauricular pain, and herpetiform vesicles. The reported incidence in children is 2.7/100,000. The pathogenesis involves the reactivation of latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. The recovery rate is better in children than in adults. This paper discusses a 12-year-old girl with a rare case of peripheral facial paralysis caused by RHS and reviews the literature.
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Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear 2014; 18:18/0/2331216514541361. [PMID: 25080364 PMCID: PMC4222184 DOI: 10.1177/2331216514541361] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A number of viral infections can cause hearing loss. Hearing loss induced by these viruses can be congenital or acquired, unilateral or bilateral. Certain viral infections can directly damage inner ear structures, others can induce inflammatory responses which then cause this damage, and still others can increase susceptibility or bacterial or fungal infection, leading to hearing loss. Typically, virus-induced hearing loss is sensorineural, although conductive and mixed hearing losses can be seen following infection with certain viruses. Occasionally, recovery of hearing after these infections can occur spontaneously. Most importantly, some of these viral infections can be prevented or treated. For many of these viruses, guidelines for their treatment or prevention have recently been revised. In this review, we outline many of the viruses that cause hearing loss, their epidemiology, course, prevention, and treatment.
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Affiliation(s)
| | - Anne Durstenfeld
- Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA
| | - Pamela C Roehm
- Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia, PA, USA
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Costa A, Veiga A. Ramsay-Hunt syndrome in the differential diagnosis of stroke. Rev Soc Bras Med Trop 2013; 46:663. [PMID: 24270261 DOI: 10.1590/0037-8682-0164-2013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 09/20/2013] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alexandre Costa
- Departamento de Neurologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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