Teggi Roberto, Del Poggio Anna, Cangiano Iacopo, Nobile Alessandro, Gatti Omar, Bussi Mario
Otolaryngology Department, San Raffaele Scientific Institute, 20132 Milan, Italy.
Department of Neuroradiology and CERMAC, San Raffaele Hospital, 20132 Milan, Italy.
J Clin Med. 2023 Sep 26;12(19):6206. doi: 10.3390/jcm12196206.
The varicella-zoster virus (VZV), a member of the Herpesviridae family, causes both the initial varicella infection and subsequent zoster episodes. Disorders of the eighth cranial nerve are common in people with herpes zoster oticus (HZO). We performed a review of the literature on different databases including PubMed and SCOPUS, focusing on cochlear and vestibular symptoms; 38 studies were considered in our review. A high percentage of cases of HZO provokes cochlear and vestibular symptoms, hearing loss and vertigo, whose onset is normally preceded by vesicles on the external ear. It is still under debate if the sites of damage are the inferior/superior vestibular nerves and cochlear nerves or a direct localization of the infection in the inner ear. The involvement of other contiguous cranial nerves has also been reported in a few cases. We report the case of a patient with single-side HZO presenting clinical manifestations of cochleo-vestibular damage without neurological and meningeal signs; after 15 days, the patient developed a new episode of vertigo with clinical findings of acute contralateral vestibular loss. To our knowledge, only three other such cases have been published. An autoimmune etiology may be considered to explain these findings.
水痘带状疱疹病毒（VZV）是疱疹病毒科的一员，可引起初次水痘感染及随后的带状疱疹发作。第八颅神经紊乱在耳带状疱疹（HZO）患者中很常见。我们对包括PubMed和SCOPUS在内的不同数据库中的文献进行了综述，重点关注耳蜗和前庭症状；我们的综述纳入了38项研究。高比例的HZO病例会引发耳蜗和前庭症状、听力损失和眩晕，其发作通常在外耳出现水疱之前。损伤部位是前庭下/上神经和耳蜗神经还是感染直接定位于内耳仍存在争议。少数病例还报告了其他相邻颅神经的受累情况。我们报告了一例单侧HZO患者，其临床表现为耳蜗 - 前庭损伤且无神经和脑膜体征；15天后，患者出现了新的眩晕发作，伴有急性对侧前庭丧失的临床表现。据我们所知，仅另外发表过三例此类病例。可以考虑自身免疫病因来解释这些发现。
