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- $Unique_ID{BRK03818}
- $Pretitle{}
- $Title{Herpes Zoster}
- $Subject{Herpes Zoster Shingles Zona Acute Posterior Ganglionitis Geniculate
- Zoster, also known as Ramsay Hunt Syndrome Ophthalmic Herpes Zoster Bell's
- Palsy Chickenpox Herpes Simplex (Cold Sores) Trigeminal Neuralgia (Tic
- Douloureux) }
- $Volume{}
- $Log{}
-
- Copyright (C) 1987, 1988, 1989, 1991 National Organization for Rare
- Disorders, Inc.
-
- 457:
- Herpes Zoster
-
- ** IMPORTANT **
- It is possible the main title of the article (Herpes Zoster) is not the
- name you expected. Please check the SYNONYMS listing on the next page to
- find alternate names, disorder subdivisions, and related disorders covered by
- this article.
-
- Synonyms
-
- Shingles
- Zona
- Acute Posterior Ganglionitis
-
- DISORDER SUBDIVISIONS
-
- Geniculate Zoster, also known as Ramsay Hunt Syndrome
- Ophthalmic Herpes Zoster
-
- Information on the following disorders may be found in the Related
- Disorders section of this report:
-
- Bell's Palsy
- Chickenpox
- Herpes Simplex (Cold Sores)
- Trigeminal Neuralgia (Tic Douloureux)
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Herpes Zoster is a common central nervous system infection caused by the
- varicella-zoster virus. This is the same virus that causes chickenpox. The
- disorder is characterized by eruption of blisters, nerve pain, and severe
- itching of the skin.
-
- Symptoms
-
- Preliminary symptoms of Herpes Zoster include chills, fever, and a feeling of
- discomfort three or four days before distinctive features of the disease
- develop. Pain may or may not occur along the site of the future skin
- eruption. On the 4th or 5th day, characteristic crops of blisters appear on
- a red base, distributed on skin areas that are served by one or more
- posterior root nerve centers (ganglia) along the spine. The involved skin
- area is usually hypersensitive, and the associated pain may be severe. The
- eruptions occur most often in the chest area and may spread only on one side
- of the body. They begin to dry and form scabs about the 5th day after their
- appearance. Herpes Zoster rarely becomes generalized. If it spreads or if
- the lesions persist beyond two weeks, additional special medical evaluation
- may be necessary.
-
- One attack of Herpes Zoster usually gives the patient immunity from
- subsequent attacks. Most patients recover without any after effects except
- for occasional scarring of the skin. However, in a minority of cases, nerve
- pain (neuralgia) may persist for months or years, most frequently in elderly
- persons.
-
- Geniculate Zoster (Herpes Zoster Oticus or Ramsay Hunt Syndrome) involves
- part of the facial nerve near the internal ear (geniculate ganglion). Pain
- in the ear and facial paralysis (rarely permanent) may occur on the affected
- side. Blisters may erupt in the external ear canal, the outer ear, the soft
- palate, and the top part of the throat.
-
- Ophthalmic Herpes Zoster involves Herpes Zoster affecting the ganglion of
- the fifth cranial nerve (trigeminal or gasserian ganglion). Pain and an
- eruption of blisters in the distribution of the branch of the 5th nerve
- serving the eye occur. A 3rd nerve paralysis may be present. Blisters on
- the tip of the nose indicate that the branch of the 5th nerve serving the
- nose, eyes, eyebrows (nasociliary branch) and the cornea are involved.
- Development of corneal ulcerations and clouding may also occur.
-
- Causes
-
- Herpes Zoster is caused by the varicella-zoster virus, the same virus that
- causes chickenpox. This virus may be activated by local lesions involving
- the posterior root nerve ganglia, by diseases involving a decreased immune
- system (particularly Hodgkin's disease), or by immunosuppressive drugs.
-
- Affected Population
-
- Herpes Zoster is a common viral infection which may occur at any age.
- However, it is most common after age 50. It affects males and females in
- equal numbers. While the disorder is common for the elderly population,
- long-term complications of Herpes Zoster are rare, and in rare cases,
- children or young adults may be affected.
-
- Related Disorders
-
- Symptoms of the following disorders may be similar to those of Herpes Zoster.
- Comparisons may be useful for a differential diagnosis:
-
- Bell's Palsy is a one-sided facial paralysis of sudden onset resulting
- from inflammation and/or compression of the facial nerve (cranial nerve VII).
- It is nonprogressive, benign, and may be partial or complete. The affected
- muscles usually regain their function after one or two months, although in
- cases of extensive nerve damage, all or part of the paralysis may be
- permanent. (For more information on this disorder, choose "Bell's Palsy" as
- your search term in the Rare Disease Database.)
-
- Chickenpox is an acute children's disease which is caused by the same
- Herpes Zoster virus. It usually begins with mild constitutional symptoms
- such as a mild headache, moderate fever and discomfort followed by an
- eruption appearing in itchy crops of flat or elevated spots and blisters,
- which form crusts. It is highly contagious.
-
- Herpes Simplex (Fever Blister; Cold Sore) is a recurrent infection by the
- relatively large herpes simplex virus. It is characterized by the appearance
- on the skin or mucous membranes of clusters of small blisters, filled with
- clear fluid on slightly raised inflamed bases. There are two types of Herpes
- Simplex. Type 1 causes infections around the lips and in the cornea. Type 2
- usually affects the genital areas and is transmitted primarily by direct
- contact with lesions, most often during sexual intercourse.
-
- Trigeminal Neuralgia (Tic Douloureux) is a nerve disorder characterized
- by attacks of acute pain at the side of the mouth and nose, along the
- distribution of the trigeminal nerve. (For more information on this
- disorder, choose "Trigeminal" as your search term in the Rare Disease
- Database.)
-
- Therapies: Standard
-
- There is no specific therapy for Herpes Zoster. However, corticosteroids (if
- given early), may relieve pain in severe cases. Locally applied wet
- compresses may be soothing. Aspirin, alone or with codeine, may relieve
- pain. Immunosuppressed patients with Herpes Zoster may benefit from
- treatment with the antiviral drug adenine arabinoside (vidarabine), or
- intravenous immunoglobulin. Immunoglobulin can also be beneficial for
- prevention of Herpes Zoster infection in immune suppressed patients.
-
- The drug Zovirax (aciclovir) is now listed as standard therapy for Herpes
- Zoster. It is manufactured by Burroughs-Wellcome.
-
- Therapies: Investigational
-
- Transfer factor from a Herpes Zoster patient during the healing phase is
- being tested as treatment for immunosuppressed patients. Postherpetic
- neuralgia (intractable pain following shingles) has been observed in rare
- cases. Zostrix (capsaicin), a new drug for treating this pain, was
- introduced into the United States and Canada in 1987. For more information,
- physicians can contact:
-
- GenDerm Corporation
- 425 Huehl Road
- Northbrook, IL 60062
- (312) 382-7404
-
- Skin eruptions may heal faster with fibroblast interferon infused into
- the abdominal cavity. Low-frequency electrotherapy has also been used
- successfully. However, more research with these forms of treatment is needed
- to establish their safety and effectiveness. Injection of anesthetics into
- the painful nerves (nerve block) has been found beneficial for severe cases
- of postherpetic neuralgia.
-
- Clinical trials are being conducted on the experimental drug Arabinosyl
- adenine (ARA-A) for treatment of Herpes Zoster (shingles). For additional
- information, physicians can contact:
-
- Ives Laboratories
- Professional Service
- P.O. Box 8299
- Philadelphia, PA 19101
-
- This disease entry is based upon medical information available through
- September 1989. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Herpes Zoster, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Allergy and Infections Diseases (NIAID)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5717
-
- Centers for Disease Control (CDC)
- 1600 Clifton Road, NE
- Atlanta, GA 30333
- (404) 639-3534
-
- References
-
- THE CLINICAL APPLICATION OF FIBROBLAST INTERFERON -- AN OVERVIEW: A.
- Biliau; Med Oncol Tumor Pharmacother (1984: issue 1(2)). Pp. 87-96.
-
- VARICELLA AND HERPES ZOSTER IN IMMUNOSUPPRESSED CHILDREN: PRELIMINARY
- RESULTS OF TREATMENT WITH INTRAVENOUS IMMUNOGLOBULIN: J.M. Sullinger, et
- al.; Helv Paediatr Acta (March 1984: issue 39(1)). Pp. 63-70.
-
- INTERFERON FOR THE TREATMENT OF INFECTIONS: M. Ho; Annu Rev Med (1987:
- issue 38). Pp. 51-59.
-
- PHYSICAL TREATMENT OF HERPETIC DISEASES. REPORT OF A PILOT STUDY WITH
- LOW-FREQUENCY ELECTROTHERAPY: L. Hein, et al.; Wien Klin Wochenschr (March
- 6, 1987: issue 99(5)). Pp. 149-153.
-
-