HZO Complications

In order to avoid the possible complications of Herpes Zoster Oticus, it should be treated as a serious disease which requires superior treatment to maximize facial nerve recovery. From this angle, the possible complications of herpes zoster oticus should be clearly understood. If the patient is early diagnosed and takes the proper treatment within the first 3 days, majority of the patient population would not suffer from the possible long-term complications. However clinic evidence reflect that in some cases even patient starts to an early treatment he/she can still suffer from the long term complications like permanent hearing loss and facial weakness.

Please find below the possible complications that patients may experience who have Herpes Zoster Oticus:

• Permanent  complications
• facial paralysis
• hearing loss ( hearing impairment)
• Eye damage where the facial weakness caused by herpes zoster oticus may make it difficult for patients to close their eyelid on the side of your face that's affected. Incomplete eyelid closure may harm the protective dome of clear tissue over the front of your eye (cornea). This damage may cause blurred vision and eye pain.
• Rare complications where the varicella zoster virus spreads to brain, spinal cord or other nerves
• Headache
• Back pain
• Limb weakness
• Confusion
• Lethargy
• Postherpetic neuralgia because of nerve fiber damage. Damaged fibers are not capable to send messages from patient’s skin to their brain as they normally function.  Alternately, the messages turned into be exaggerated and confused, causing pain that may carry through long after other symptoms of herpes zoster oticus have disappeared.
• Possible taste loss
• Unusual facial movements namely synkinesis.  This complication may exist if the infection severely damages patient’s facial nerve and the nerve grows back to the wrong place. This may end with inappropriate nerve responses, like blinking or tears when you're laughing, chewing or talking.
• SEVERE COMPLICATIONS (BECAUSE OF HERPES ZOSTER)
• Neurological complications. (some of them has been mentioned above like permanent hearing loss)-
• Sensory loss
• Deafness
• Post-herpetic neuralgia (PHN)
• Meningo-encephalitis
• Aseptic meningitis
• Transverse myelitis
• Peripheral nerve palsies
• Ascending myelitis
• Cranial nerve palsies
• Diaphragmatic paralysis
• Vestibular dysfunction
• Cicatricial lid scarring
• Granulomatous cerebral angiitis
• Ocular complications
• Keratitis
• Loss of corneal sensation
• Scleritis
• Panophthalmitis
• Chorioretinitis
• Uveitis
• Optic neuropathy
• Iridocyclitis
• Mydriasis
• Ptosis
• Secondary glaucoma
• Progressive outer retinal necrosis
• Acute retinal necrosis
• Visceral complications
• Neural extension of VZV ( Varicella Zoster Virus) infection
• Oesophagitis
• Bronchitis
• Colitis
• Gastritis
• Myositis
• Cystitis
• Peritonitis
• Pericarditis
• Pleuritis
• Visceral VZV dissemination
• Hepatitis
• Pneumonia
• Myocarditis
• Arthritis
• Pericarditis
• Bacterial superinfection
• Cellulitis
• Septicaemia
• Scarring
• Zoster gangrenosum

Please find below the conclusions regarding to severe complications of Herpes Zoster:

• Further research is required to define the incidence and burden of herpes zoster complications, other than post-herpetic neuralgia (PHN), in different regions and populations (research need recommendation)
• Oral antiviral therapy should be offered to patients presenting with herpes zoster ophthalmicus to reduce ocular complications
• Early treatment with aciclovir in combination with prednisolone should be offered to patients with Ramsay Hunt syndrome to improve outcome (category 2 recommendation)
• The efficacy of antiviral treatment of Bell’s palsy requires more extensive study (research need recommendation)