Serdar AYKAÇ, Güle ÇINAR, Işıl Deniz ALIRAVCI

Valasiklovir Tedavisi Altında Gelișen Ramsay Hunt Sendromu

Ramsay Hunt Sendromu (RHS), fasiyal sinir tutulumuna auriküler döküntü ve kulak ağrısının eșlik ettiği bir sendromdur. Fasyal paralizi geç ve sekelli düzelir. Bu makalede ilk olarak oral valasiklo-vir tedavisi bașlanan ve tedavisinin üçüncü gününde RHS gelișen, erken bașlanan intravenöz asiklovir ve steroid tedavisi ile fasiyal paralizisi tam olarak düzelen bir olgu sunulmuștur. Bu olgu çerçevesinde; yașlı, kronik hastalığı olan hastalarda oral antiviral tedaviye rağmen RHS gelișebi-leceği akılda tutulmalıdır. (Bu hastalara) Hastalığ ın ilk 72 saat içinde intravenöz antiviral tedavi yanında steroid ve antienflamatuar tedavileri de bașlanmalıdır.

Ramsay Hunt Syndrome Developed Under Valacylovir Treatment; A Case Report

Ramsay Hunt Syndrome (RHS) is a syndrome with facial nerve involvement which is accompa-nied by auricular rash and ear pain. Facial paralysis recovers late and with a sequelae. In this article, we reported a case who was first treated with oral valacyclovir and developed RHS at the third day of treatment, and whose facial paralysis fully recovered with early initiation of intrave-nous acyclovir and steroid. As it is in this case; it is important to keep in mind that RHS may develop despite oral antiviral treatment in elderly patients with chronic diseases (patients with chronic, elderly). Steroid and antiinflammatory treatments as well as intravenous antiviral the-rapy should be begun in the first 72 hours of this disease.

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17. Dickins, J.R., J.T. Smith, and S.S. Graham, Herpes zoster oticus: treatment with intravenous acyclovir. The Laryngoscope, 1988. 98(7): p. 776-779.
16. Payten, R. and J. Dawes, Herpes zoster of the head and neck. The Journal of Laryngology & Otology, 1972. 86(10): p. 1031-1055.
15. Crabtree, J.A., Herpes zoster oticus. The Laryngoscope, 1968. 78(11): p. 1853-1878.
14. Syal, R., I. Tyagi, and A. Goyal, Bilateral Ramsay Hunt syndrome in a diabetic patient. BMC Ear, Nose and Throat Disorders, 2004. 4(1): p. 3.
13. Murakami, S., et al., Treatment of ramsay hunt syndrome with acyclovir‐prednisone: Significance of early diagnosis and treatment. Annals of neurology, 1997. 41(3): p. 353-357.
12. Stafford, F. and A. Welch, The use of acyclovir in Ramsay Hunt syndrome. The Journal of Laryngology & Otology, 1986. 100(3): p. 337-340.
11. Yetişer, S., et al., Herpes zoster otikusta oral asiklovir tedavisi sonuçları. Otoskop, 2002. 1(3): p. 19-23.
10. Kucur, C., et al., Tekrarlayan Periferik Fasiyal Paralizili Hastalarda Ayırıcı Tanı.
9. Cihan, Y.B. and A. Turasan, Kanserli hastalarda radyoterapi sonrasi herpes zoster/Herpes zoster in cancer patients after radiotherapy. Turkderm, 2013. 47(3): p. 170.
8. Ocak, D., İ. Tutar, and A. Yıdılrım, Ramsay-Hunt sendromlu bir olgu sunumu: elektrostimülasyonla tedavi edilen periferik fasiyal paralizi. Turk J Phys Med Rehab, 2005. 51: p. 111-113.
7. Sobn, A. and P.A. Tranmer, Ramsay Hunt syndrome in a patient with human immunodeficiency virus infection. The Journal of the American Board of Family Practice, 2001. 14(5): p. 392-394.
6. HIZ, F., et al., Kraniyal ve Servi kal Dermatom Tutulumlu Ramsay Hunt Sendromu Olgusu. Journal of Kartal Training & Research Hospital/Kartal Egitim ve Arastirma Hastanesi Tip Dergisi, 2012. 23(3).
5. Baba, M., et al., Atipik seyirli Ramsay Hunt sendromlu bir olgu. Türkderm, 2006. 40: p. B80-1.
4. McCrary, M.L., J. Severson, and S.K. Tyring, Varicella zoster virus. Journal of the American Academy of Dermatology, 1999. 41(1): p. 1-16.
3. Furuta, Y., et al., Varicella-zoster virus DNA level and facial paralysis in Ramsay Hunt syndrome. Annals of Otology, Rhinology & Laryngology, 2004. 113(9): p. 700-705.
2. Robillard, R.B., R.L. Hilsinger Jr, and K.K. Adour, Ramsay Hunt facial paralysis: clinical analyses of 185 patients. Otolaryngology-- Head and Neck Surgery, 1986. 95(3_part_1): p. 292-297.
1. Whitley, R.J., A 70-year-old woman with shingles: review of herpes zoster. Jama, 2009. 302(1): p. 73-80.