Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N
Department of Otolaryngology, Ehime University School of Medicine, Japan.
Ann Neurol. 1997 Mar;41(3):353-7. doi: 10.1002/ana.410410310.
Although the antiviral agent acyclovir is currently used for the treatment of Ramsay Hunt syndrome, its effects on facial nerve and hearing recovery remain controversial. We retrospectively analyzed the effects of acyclovir-prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days after onset, recovery from facial paralysis was complete in only 7 (30%). A significant difference in facial nerve recovery was found between these groups. Early administration of acyclovir-prednisone was proved to reduce nerve degeneration by nerve excitability testing. Hearing recovery also tended to be better in patients with early treatment. There was no significant difference in facial nerve outcome between intravenous and oral acyclovir treatment.
虽然抗病毒药物阿昔洛韦目前用于治疗拉姆齐·亨特综合征，但其对面神经和听力恢复的效果仍存在争议。我们回顾性分析了阿昔洛韦联合泼尼松治疗80例拉姆齐·亨特综合征患者的效果。在28例面神经麻痹发病3天内开始治疗的患者中，21例（75%）麻痹完全恢复。相比之下，在23例发病7天以上开始治疗的患者中，仅7例（30%）面神经麻痹完全恢复。这些组之间在面神经恢复方面存在显著差异。通过神经兴奋性测试证明，早期给予阿昔洛韦联合泼尼松可减少神经变性。早期治疗的患者听力恢复也往往更好。静脉注射和口服阿昔洛韦治疗在面神经预后方面没有显著差异。
