Abstract
Purpose
Cranial polyneuropathy (CP) is a rare complication of herpes zoster (HZ) infection. This entity often produces situations of a diagnostic dilemma, as can be seen in a wide spectrum of clinical presentations. The aim of this study was to report the clinical characteristics, treatment, and outcomes of 11 patients from a single-institution experience.
Methods
A retrospective analysis of patients treated for HZ CP over a 12-year period was performed.
Results
The present study included 11 patients with CP caused by HZ infection—7 (63.63%) females, and 4 (36.36%) males. The mean age at presentation was 63 years (range, 38–85 years). Cranial nerve VII was affected in nine (81.82%) cases, CN VIII in six (54.55%) cases, CN V in five (45.45%) cases, CN III and IX in two (18.18%) cases, and CN VI and X in one (9.09%) case. The treatment of choice was acyclovir in all patients, while corticosteroids were administered in six (54.55%) patients. Complete CN recovery was observed in seven (63.63%) patients, while four (36.36%) patients suffered from permanent CN damage—two (18.18%) CN VII, one (9.09%) CN VII and VIII, and one (9.09%) CN VI.
Conclusion
Herpes zoster CP presents an interesting diagnostic and therapeutic challenge. Successful management of these patients depends on a thorough knowledge of the anatomy and topodiagnostic of CNs. Early administration of antiviral agents is crucial in terms of responsiveness to treatment and expedite recovery.
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JPB: conceptualization, methodology, writing. APB: conceptualization, investigation, writing. VT: resources, validation. IB: resources, supervision.
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Pupić-Bakrač, J., Pupić-Bakrač, A., Terkeš, V. et al. Cranial polyneuropathy caused by herpes zoster infection: a retrospective single-center analysis. Eur Arch Otorhinolaryngol 278, 517–523 (2021). https://doi.org/10.1007/s00405-020-06279-y
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DOI: https://doi.org/10.1007/s00405-020-06279-y