Herpes zoster oticus presenting with facial nerve involvement — Ramsay Hunt syndrome — alongside severe pain and paralysis of multiple cranial nerves represents a clinically complex presentation requiring prompt, targeted management.
Ramsay Hunt syndrome with confirmed facial nerve involvement, severe pain, and multiple cranial nerve palsies. This combination of findings signals a more demanding disease course and shapes the treatment strategy.
Current recommendations support a combination strategy involving intravenous antiviral therapy together with systemic corticosteroids. The complete sequence, step-down approach, and management of associated symptoms are detailed in the full protocol.
Primary treatment goal: restoration of facial nerve function.
DOI: 10.1111/ddg.14013
In patients with herpes zoster oticus and facial nerve involvement (Ramsay Hunt syndrome), severe pain and/or paralysis of multiple cranial nerves, it is recommended to administer combination treatment consisting of intravenous acyclovir and systemic corticosteroids.
Combination treatment is more effective in restoring facial nerve function following herpes zoster oticus and seems to be associated with a more favorable prognosis.
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