Ipsilateral vestibulopathy after herpes zoster infection

Abstract

Patients suffering from herpes zoster virus (HZV) may exhibit a variety of symptoms regarding cochleovestibular dysfunction. Among those include vertigo, hearing loss and others include facial paralysis. The function of all three semicircular canals can be examined using video-head-impulse test (vHIT), and as a result, gain parameter, which is the ratio of velocity of head and eye movements can be determined.In this article, a case report of a 58-year-old female with an infectious complication of HZV is presented, who only suffered from vertigo episodes, but no other accompanied symptoms. The patient was complaining of ear pain on the right side, and during her examination, HZV infection was diagnosed, therefore, oral acyclovir antiviral therapy was indicated. Post-hospitalization she was complaining of vertigo, thus, neurotologic examination using vHIT was carried out. Based on vHIT, significant hypofunction of all three canals was detected on the right side, with almost normal function on the left side. Hence, intravenous steroid therapy followed by oral steroid treatment was indicated for the overall time of two weeks. At the end of the treatment, a vHIT follow-up examination was conducted, and a significant improvement of the semicircular canals function was detected, also with subjective improvement of the symptoms.This case highlights the necessity of thorough examination of the patients, and to reinforce the need of treatment by using steroid agents in patients with herper zoster oticus.

Keywords

• Vestibulopathy
• Vertigo
• Video-head-impulse test
• Unilateral hypofunction
• Steroid therapy