Vest C, Munneke J A, Smith R
Postgrad Med. 1979 Apr;65(4):143-50. doi: 10.1080/00325481.1979.11715118.
Three cases of herpes zoster oticus illustrate the manifestations of this relatively uncommon cause of facial paralysis. Topographic analysis, in which functions of facial nerve branches are assessed, helps establish the level of facial nerve involvement. Sequential faradic stimulation testing often is a sensitive prognostic indicator of recovrey of facial nerve function, particularly if nerve excitability persists. A few recent reports support the use of systemic steroid therapy for herpes zoster oticus; opinions vary regarding the efficacy of surgical decompression for facial paralysis. Although general principles cannot be deduced from three cases, each case discussed exemplifies an important aspect of management. The prognostic significance of results of nerve stimulation tests is illustrated by the complete return of facial nerve function in our first patient. Our second patient's response to systemic steroid therapy supports recent reports of the value of such agents in herpes zoster oticus. Partial return of facial nerve function in our third patient two months after onset of paralysis accentuates the importance of a period of observation before a nerve graft or other rehabilitative procedures are undertaken.
三例耳带状疱疹病例说明了这种相对罕见的面瘫病因的表现。通过评估面神经分支功能的局部解剖分析，有助于确定面神经受累的水平。连续感应电刺激测试通常是面神经功能恢复的敏感预后指标，特别是当神经兴奋性持续存在时。最近的一些报告支持对耳带状疱疹使用全身性类固醇疗法；对于面瘫的手术减压疗效，观点不一。虽然不能从三个病例中推断出一般原则，但所讨论的每个病例都例证了管理的一个重要方面。我们的首例患者面神经功能完全恢复，说明了神经刺激测试结果的预后意义。我们的第二例患者对全身性类固醇疗法的反应支持了最近关于此类药物在耳带状疱疹中价值的报告。第三例患者在面瘫发作两个月后面神经功能部分恢复，突出了在进行神经移植或其他康复手术之前进行一段观察期的重要性。
