The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Shingo Murakami - One of the best experts on this subject based on the ideXlab platform.
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concurrent treatment with intratympanic dexamethasone improves facial nerve recovery in Ramsay Hunt Syndrome
Journal of the Neurological Sciences, 2020Co-Authors: Akira Inagaki, Toshiya Minakata, Sachiyo Katsumi, Shingo MurakamiAbstract:Abstract Objective To determine whether early intervention with intratympanic steroid injections, known as concurrent intratympanic steroid therapy (ITST), is an effective supplement to systemic steroid therapy for moderately-severe to severe Ramsay Hunt Syndrome. Methods Forty-six patients with Ramsay Hunt Syndrome (House-Brackmann grade IV or higher) who received either concurrent ITST with standard systemic steroid therapy (ITST group, n = 12) or standard systemic therapy alone (control group, n = 34) with antivirals starting within 7 days of onset. Patients in the concurrent ITST group received the standard systemic dose of prednisolone (410 mg in total) and intratympanic dexamethasone (16.5 mg in total) over 10 consecutive days. Patients in the control group received systemic prednisolone at the standard dose or higher (average dose, 581 ± 25 mg). Results The recovery rate was higher in the concurrent ITST group than in the control group (93% vs 47%, P = .013). The adjusted odds ratio was 22.2 (95% confidence interval 1.32–373.58, P = .031). Conclusions The recovery rate was higher after concurrent systemic and intratympanic steroid therapy than after standard systemic steroid therapy, regardless of whether the steroid used had lower or equivalent glucocorticoid potency. This finding suggests that concurrent intratympanic steroid therapy is a beneficial supplement in patients with Ramsay Hunt Syndrome.
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swelling of the intratemporal facial nerve in Ramsay Hunt Syndrome
Acta Oto-laryngologica, 2002Co-Authors: Nobumitsu Honda, Naohito Hato, Hisanobu Kisaki, Naoaki Yanagihara, Shingo MurakamiAbstract:Although Ramsay Hunt Syndrome is one of the most important diseases causing peripheral facial palsy, the detailed pathology of the disease in the intratemporal facial nerve remains unclear. The purpose of this study was to increase knowledge of the pathogenesis of the Syndrome by means of surgical findings. Between April 1976 and March 1997 we performed subtotal decompression of the facial nerve in 74 patients with severe Ramsay Hunt Syndrome. The grade of nerve swelling was assessed using a microscope and recorded in a standardized form. The relationships between nerve swelling, the timing of surgery and the swelling of each segment were analyzed. Pronounced neural swelling, involving the geniculate ganglion and the horizontal segment, was consistent finding in the acute phase. Although the incidence of pronounced swelling of the horizontal segment gradually declined with time after onset, in most cases nerve swelling persisted even beyond the 16th week after onset. These data suggest that diffuse viral ...
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Ramsay Hunt Syndrome in children
Annals of Neurology, 2000Co-Authors: Naohito Hato, Hisanobu Kisaki, Nobumitsu Honda, Shingo Murakami, Naoaki YanagiharaAbstract:In a retrospective study, 52 children were diagnosed with Ramsay Hunt Syndrome. The facial palsy was milder and complete recovery of the function was achieved in 78.6% of patients. Associated cranial neuropathies were less common in children than in adults. The timing of vesicle appearance tended to be delayed in children. In preschool children, Ramsay Hunt Syndrome was rare, although the frequency has recently increased. The Syndrome is relatively common in older children. This study suggested that vaccination can prevent or reduce the occurrence of Ramsay Hunt Syndrome. Ann Neurol 2000;48:254–256
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varicella zoster virus distribution in Ramsay Hunt Syndrome revealed by polymerase chain reaction
Acta Oto-laryngologica, 1998Co-Authors: Shingo Murakami, Naohito Hato, Yuki Nakashiro, Mutsuhiko Mizobuchi, Nobumitsu HondaAbstract:The pathogenesis of facial nerve paralysis and vestibulo-cochlear dysfunction of Ramsay Hunt Syndrome remains unclear as varicella-zoster virus (VZV) has not been demonstrated in the lesions. Using the polymerase chain reaction, we detected VZV genomes not only in the vesicles on the auricles or oral cavity but also in the facial nerve sheath, middle ear mucosa and cerebrospinal fluid from patients with Ramsay Hunt Syndrome. The VZV genome was undetectable in the same kinds of clinical samples obtained from control patients with facial nerve paralysis of other etiologies. The results indicated that VZV spreads widely in the neural components, mucocutaneous tissue and cerebrospinal fluid. The present study will facilitate better understanding of the pathogenesis of facial nerve paralysis, vertigo, hearing impairment and other cranial nerve dysfunction of Ramsay Hunt Syndrome.
Martin J Burton - One of the best experts on this subject based on the ideXlab platform.
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antiviral therapy for Ramsay Hunt Syndrome herpes zoster oticus with facial palsy in adults
Cochrane Database of Systematic Reviews, 2008Co-Authors: Teresa Uscategui, Carolyn Doree, Ian J Chamberlain, Martin J BurtonAbstract:Background Herpes zoster oticus (HZO) is a viral infection of the ear and when associated with acute facial paralysis is known as Ramsay Hunt Syndrome. Antiviral agents are the standard first-line treatment for herpes zoster infections at other body sites and are thought to reduce or minimise nerve damage, thereby improving outcomes. It has been suggested that these agents improve the chance of facial weakness improving or resolving completely in patients with Ramsay Hunt Syndrome. Objectives To determine the effectiveness of antiviral agents in the treatment of adult patients with Ramsay Hunt Syndrome (HZO with facial palsy). Search methods We searched the Cochrane ENT Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, current issue), Medline (1950 - 2007), PubMed 2007 - 2008, EMBASE (1974 onwards) and other relevant databases. The date of the most recent search was June 2008. Selection criteria Two authors scrutinized all possible citations to identify randomised controlled trials in which antiviral agents alone or in combination with other therapies (using different routes of administration and dosage schemes) were given as treatment for Ramsay Hunt Syndrome. We contacted an author for further information. Data collection and analysis Two reviewers independently assessed eligibility and trial quality. Main results Only one randomised, controlled trial was identified and included. It was of low quality and included only 15 participants. In this 1992 trial, intravenous acyclovir and corticosteroids were compared with corticosteroids alone. Our analysis found no statistically significant difference between the two groups. Authors' conclusions We found no evidence that anti-viral agents have a beneficial effect on outcomes in Ramsay Hunt Syndrome, despite their widespread use in this condition. The use of these drugs in patients with herpes zoster infections in other parts of the body might suggest that they have a role in herpes zoster oticus. As usual, the absence of positive evidence of benefit (or, in this case, the 'negative' result of one small, statistically under-powered study) does not necessarily indicate that antivirals are ineffective. However, these drugs are associated with a number of adverse effects and this must be taken into consideration when undertaking the requisite risk-benefit analysis before instigating treatment.
Nobumitsu Honda - One of the best experts on this subject based on the ideXlab platform.
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swelling of the intratemporal facial nerve in Ramsay Hunt Syndrome
Acta Oto-laryngologica, 2002Co-Authors: Nobumitsu Honda, Naohito Hato, Hisanobu Kisaki, Naoaki Yanagihara, Shingo MurakamiAbstract:Although Ramsay Hunt Syndrome is one of the most important diseases causing peripheral facial palsy, the detailed pathology of the disease in the intratemporal facial nerve remains unclear. The purpose of this study was to increase knowledge of the pathogenesis of the Syndrome by means of surgical findings. Between April 1976 and March 1997 we performed subtotal decompression of the facial nerve in 74 patients with severe Ramsay Hunt Syndrome. The grade of nerve swelling was assessed using a microscope and recorded in a standardized form. The relationships between nerve swelling, the timing of surgery and the swelling of each segment were analyzed. Pronounced neural swelling, involving the geniculate ganglion and the horizontal segment, was consistent finding in the acute phase. Although the incidence of pronounced swelling of the horizontal segment gradually declined with time after onset, in most cases nerve swelling persisted even beyond the 16th week after onset. These data suggest that diffuse viral ...
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Ramsay Hunt Syndrome in children
Annals of Neurology, 2000Co-Authors: Naohito Hato, Hisanobu Kisaki, Nobumitsu Honda, Shingo Murakami, Naoaki YanagiharaAbstract:In a retrospective study, 52 children were diagnosed with Ramsay Hunt Syndrome. The facial palsy was milder and complete recovery of the function was achieved in 78.6% of patients. Associated cranial neuropathies were less common in children than in adults. The timing of vesicle appearance tended to be delayed in children. In preschool children, Ramsay Hunt Syndrome was rare, although the frequency has recently increased. The Syndrome is relatively common in older children. This study suggested that vaccination can prevent or reduce the occurrence of Ramsay Hunt Syndrome. Ann Neurol 2000;48:254–256
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varicella zoster virus distribution in Ramsay Hunt Syndrome revealed by polymerase chain reaction
Acta Oto-laryngologica, 1998Co-Authors: Shingo Murakami, Naohito Hato, Yuki Nakashiro, Mutsuhiko Mizobuchi, Nobumitsu HondaAbstract:The pathogenesis of facial nerve paralysis and vestibulo-cochlear dysfunction of Ramsay Hunt Syndrome remains unclear as varicella-zoster virus (VZV) has not been demonstrated in the lesions. Using the polymerase chain reaction, we detected VZV genomes not only in the vesicles on the auricles or oral cavity but also in the facial nerve sheath, middle ear mucosa and cerebrospinal fluid from patients with Ramsay Hunt Syndrome. The VZV genome was undetectable in the same kinds of clinical samples obtained from control patients with facial nerve paralysis of other etiologies. The results indicated that VZV spreads widely in the neural components, mucocutaneous tissue and cerebrospinal fluid. The present study will facilitate better understanding of the pathogenesis of facial nerve paralysis, vertigo, hearing impairment and other cranial nerve dysfunction of Ramsay Hunt Syndrome.
Sun O Chang - One of the best experts on this subject based on the ideXlab platform.
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prognosis of Ramsay Hunt Syndrome presenting as cranial polyneuropathy
Laryngoscope, 2010Co-Authors: Moon Young Chang, Hak Hyun Jung, Yongsoo Park, Seung Ha Oh, Sun O ChangAbstract:OBJECTIVES/HYPOTHESIS: Ramsay Hunt Syndrome is known to be accompanied with cranial polyneuropathy very occasionally. We reviewed our experience to analyze the clinical manifestations and prognosis of these cases. STUDY DESIGN: Retrospective review. METHODS: Eleven patients with Ramsay Hunt Syndrome presenting as cranial polyneuropathy between 1999 and 2009 were included in this study retrospectively. All patients were treated with systemic steroids and antiviral agents. Assessment of recovery from facial nerve palsy (FNP) using the House-Brackmann (HB) grading system was performed, and the follow-up period was 4 to 28 months. RESULTS: The patient numbers for the initial degree of FNP were five for HB grade II, one for grade III, two for grade IV, and three for grade V. The cochleovestibular nerve was involved in 10 cases, and hearing loss was observed in nine patients. Other involved cranial nerves were IX in seven cases, X in five cases, V in three cases, and III/XII in one case each. Antiviral agents and steroids were administered within 3 days after the onset of symptoms for about 1 to 2 weeks in most cases. After the treatment the degree of FNP improved to HB grade I or II in nine of 11 patients (81.8%). Symptoms of other cranial nerves also improved in most patients, whereas recovery for hearing loss showed poor results. CONCLUSIONS: Ramsay Hunt Syndrome associated with cranial polyneuropathy has a good prognosis for FNP and other cranial nerve palsies with a combination therapy of antiviral agents and steroids, but not for recovery of hearing loss.
Seong Il Kang - One of the best experts on this subject based on the ideXlab platform.
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a case of Ramsay Hunt Syndrome with cranial polyneuropathy
Korean Journal of Audiology, 2012Co-Authors: Seong Il KangAbstract:Ramsay Hunt Syndrome is an infectious disease caused by the varicella zoster virus. It is characterized by the symptoms of facial paralysis, otalgia, and erythematous vesicular rash on the auricle and/or oral cavity. We present a case of a patient with clinical evidence of Ramsay Hunt Syndrome involving the cranial nerves VI, VII, and VIII. The patient, a 66-year-old woman, showed left facial palsy associated with vesicular eruptions on her left auricle, impaired gaze to left side, and left hearing loss. Four months after the treatment with systemic steroid and antiviral agents, her all symptoms and signs including facial paralysis and diplopia disappeared.
