Considerazioni clinico terapeutiche su alcuni casi di Herpes Zoster Oticus

The H.Z. oticus is a viral disease clinically characterized by paralysis of facial nerve, vesicular eruption, deafness and vertigo. The virus responsible is a relatively large virus DNA (204 x 240 micron) and it is the same as that which causes chicken pox. The disease is favoured by a reduction in the patient defence mechanisms. According to Hunt the facial nerve paralysis could be caused by edema in genicolate; according to Hilbran,on the other hand, the virus could determine more central lesions. Our 11 cases- aged 20-80 years- have been collected over a period of ten years. Almost all had chicken pox when young. Severe pain preceded eruption in 81 % of the cases; the burning pain spread to the external and to frontal, parietal, temporal regions;only in 18 % a lymphonodal reaction was present. The lesion of the acoustic nerve gave rise to neurosensoril hearing loss of various degree with recruitment and vestibular damage of the side affected. A case is described with complete symptomatology complicated by cerebellar disorders. The therapy has been aimed at removing the viral agent (metisoprinolo) to aid the recovery of the affected nerve (B1, B6, B12 vitamins, gangliosides, vasodilators, corticosteroids) must be given with caution in order not to interfere with immunity mechanisms.Electrostimolation and kinesitherapy seem to be useful where as radiotherapy seems to dangerous.