From the Department of Neurology (D.A.Y., T.I.), and Department of Neuroradiology (M.S.P.A.), Dr. Cesar Milstein Hospital, Buenos Aires, Argentina; Department of Neurology (M.C.), Feinberg School of Medicine, Northwestern University, Chicago; and Department of Neurology (M.C.), University of Chicago, IL.
Neurology. 2023 Oct 3;101(14):e1461-e1465. doi: 10.1212/WNL.0000000000207549. Epub 2023 Jul 17.
Herpes zoster oticus (HZO) typically provokes vestibular symptoms and is traditionally viewed as a cranial nerve equivalent of shingles, but in contrast to vestibular neuritis (VN), it is unclear whether the pathology of HZO is limited to the vestibular nerve (neuritis) or can also involve the brainstem (nucleitis).
We retrospectively compared brain MRIs of patients with HZO with those of patients with VN to study radiologic changes in the brainstem.
Five of 10 patients with HZO showed signal abnormalities in the vestibular nuclei, which lie in multiple vascular territories, whereas no patients with VN exhibited such findings.
HZO may at least in part reflect vestibular nucleitis, as opposed to a pure neuritis.
耳带状疱疹(HZO)通常会引起前庭症状,传统上被视为带状疱疹的颅神经等效物,但与前庭神经炎(VN)不同的是,HZO 的病理是否仅限于前庭神经(神经炎),还是也可累及脑干(核炎)尚不清楚。
我们回顾性比较了 HZO 患者和 VN 患者的脑部 MRI,以研究脑干的放射学变化。
10 例 HZO 患者中有 5 例前庭核出现信号异常,这些核位于多个血管区域,而 VN 患者则无此发现。
HZO 至少部分反映了前庭核炎,而不是单纯的神经炎。