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Delayed facial palsy after middle-ear surgery due to reactivation of varicella-zoster virus

Published online by Cambridge University Press:  29 June 2007

Kiyofumi Gyo*
Affiliation:
Department of Otolaryngology, Ehime University Hospital, Ehime, Japan
Nobumitsu Honda
Affiliation:
Department of Otolaryngology, Ehime University Hospital, Ehime, Japan
*
Address for correspondence: Kiyofumi Gyo M.D., Department of Otolaryngology, Ehime University Hospital, Onsengun, Shigenobu-cho, Ehime, 791-02, Japan

Abstract

Viral reactivation is thought to be an important cause of post-operative facial palsy of delayed onset. We present an unusual case of Ramsay-Hunt syndrome that occurred as a consequence of middle-ear surgery by triggering varicella-zoster virus reactivation. As a pathognomonic auricular eruption was not seen, the patient was initially misdiagnosed as iatrogenic facial palsy. Clinical features, diagnosis and management are discussed.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1999

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References

Carton, C. A., Kilbourne, E. D. (1952) Activation of latent herpes simplex by trigeminal sensory-root section. New England Journal of Medicine 246: 172176.CrossRefGoogle ScholarPubMed
Furuta, Y., Takasu, T., Fukuda, S., Sato, K. C, Inuyama, Y., Hondo, R., Nagashima, K. (1992a) Detection of varicella-zoster virus DNA in human geniculate ganglia by polymerase chain reaction. Journal of Infectious Diseases 166: 11571159.CrossRefGoogle ScholarPubMed
Furuta, Y., Takasu, T., Sato, K. C., Fukuda, S., Inuyama, Y., Nagashima, K. (1992b) Latent herpes simplex virus type 1 in human geniculate ganglia. Ada Neuropathologica 84: 3944.CrossRefGoogle ScholarPubMed
Gianoli, G. J., Kartush, J. M. (1996) Delayed facial palsy after acoustic neuroma resection: the role of viral reactivation. American Journal of Otology 17: 625629.Google ScholarPubMed
Haverkos, H. W., Pazin, G. J., Ho, M., Nelson, P. B. (1984) Reactivation of type 2 herpes simplex virus by thoracolumbar neurosurgery. Annals of Internal Medicine 101: 503504.CrossRefGoogle ScholarPubMed
Murakami, S., Hato, N., Horiuchi, J., Honda, N., Gyo, K., Yanagihara, N. (1997) Treatment of Ramsay-Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Annals of Neurology 41: 353357.CrossRefGoogle ScholarPubMed
Murakami, S., Hato, N., Mizobuchi, M., Nakashiro, Y., Honda, N., Gyo, K. (1998a) Rapid diagnosis of varicella zoster virus infection in acute facial palsy. Neurology 51: 12021205.CrossRefGoogle ScholarPubMed
Murakami, S., Nakashiro, Y., Mizobuchi, M., Hato, N., Honda, N., Gyo, K. (1998b) Varicella-zoster virus distribution in Ramsay–Hunt syndrome revealed by polymerase chain reaction. Ada Otolaryngologica (Stockholm) 118: 145149.Google ScholarPubMed
Nabors, M. W., Francis, C. K., Kobrine, A. I. (1986) Reactivation of herpes virus in neurosurgical patients. Neurosurgery 19: 599603.CrossRefGoogle ScholarPubMed
Pazin, G. J., Ho, M., Jannetta, P. J. (1978) Reactivation of herpes simplex virus after decompression of the trigeminal nerve root. Journal of Infectious Diseases 138: 405409.CrossRefGoogle ScholarPubMed
Vrabec, J. T. (1999) Delayed facial palsy after tympanomas-toid surgery. American Journal of Otology 20: 2630.Google ScholarPubMed