Varicella Zoster Virus (VZV) and Tinnitus

[David077]

Varicella-zoster virus (VZV), is one of eight herpes viruses known to infect humans.

Auditory symptoms associated with herpes zoster or idiopathic facial paralysis.
Abstract
Auditory symptoms (hyperacusis, tinnitus, decreased hearing) have long been recognized to accompany herpetic or idiopathic facial paralysis. Twenty-nine percent of 1,080 patients with idiopathic facial paralysis and 37 percent of 172 with herpes zoster oticus facial paralysis had auditory symptoms. Abnormal related sensori-neural hearing loss was documented in only 11 of these 377 patients with auditory complaints. All of the 11 had a diagnosis of herpes zoster oticus. Sensori-neural hearing loss occurs in only about 6.5 percent of patients with herpes zoster facial paralysis, and no confirmed case of such loss in idiopathic facial paralysis has been reported. In patients presenting with sensori-neural hearing loss accompanying facial paralysis believed to be idiopathic, herpes zoster should be suspected even in the absence of vesicles. Factors favorable for recovery of auditory function include age 64 years or younger, mild initial hearing loss, a cochlear pattern of hearing loss, and absence of vertigo. Recovery of auditory function does take place; however, a high-tone sensori-neural loss may persist except in younger patients.
https://www.ncbi.nlm.nih.gov/pubmed/557156

I did a blood test for Varicella Zoster IgG which gave a result of 5, and the normal range should be between 0 to 1, that mean the amount of antibodies of VZ is 5 times higher than normal. I don't have any facial paralysis and don't recall having chickenpox in past.

I would like to hypothesize in this thread a connection (if available) between Varicella Zoster Virus (VZV) and tinnitus.

If someone has researched about VZV or has any information about it, feel free to add it here.

 

[Frédéric]

Tinnitus is not mentioned in the abstract but it is studied in the full article.

Herpes zoster oticus among pediatric patients: Our experiences at a tertiary care teaching hospital

Introduction: Herpes zoster oticus (HZO) occurs due to the reactivation of the varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. It is characterized by erythematous vesicular eruptions on the pinna and external auditory canal with severe otalgia. When it is associated with ipsilateral facial nerve paralysis, a diagnosis of Ramsay Hunt syndrome (RHS) can be made. It is rare in the pediatric age group but with low immunity, so prone for increased risk of disseminated infections, neurological complications, and recurrence of infections.

Objective: The aim of this study was to evaluate the clinical profile and management of the HZO among pediatric patients at a tertiary care teaching hospital.

Materials and Methods: In this prospective study, 24 pediatric patients of HZO were reviewed those presented during the period of December 2015–January 2020. All pediatric patients underwent thorough clinical examinations before getting the diagnosis. All the participants also underwent thorough neuro-otological and otolaryngological examinations.

Results: Out of 24 pediatric patients, 15 were boys and 9 were girls. All were in the pediatric age group with age ranging from 5 years to 16 years. After the diagnosis of HZO/RHS, all were treated with acyclovir for 10 days along with tapering dose of deflazacort, labyrinthine sedatives, and eye care in case of facial palsy. All the pediatric patients were recovered by our treatment protocol except 3 cases those are still in follow-up with facial weakness.

Conclusions: Adequate awareness for the HZO in pediatric patients is required, and the management of RHS patients is paramount among pediatrician or pediatric otorhinolaryngologists.

Full article: https://www.ijournalhs.org/article....e=13;issue=3;spage=215;epage=220;aulast=Swain