Cranial polyneuropathy caused by herpes zoster infection: a retrospective single-center analysis

Cranial polyneuropathy (CP) is a rare complication of herpes zoster (HZ) infection. This entity often produces situations of a diagnostic dilemma, as can be seen in a wide spectrum of clinical presentations. The aim of this study was to report the clinical characteristics, treatment, and outcomes of 11 patients from a single-institution experience. A retrospective analysis of patients treated for HZ CP over a 12-year period was performed. The present study included 11 patients with CP caused by HZ infection—7 (63.63%) females, and 4 (36.36%) males. The mean age at presentation was 63 years (range, 38–85 years). Cranial nerve VII was affected in nine (81.82%) cases, CN VIII in six (54.55%) cases, CN V in five (45.45%) cases, CN III and IX in two (18.18%) cases, and CN VI and X in one (9.09%) case. The treatment of choice was acyclovir in all patients, while corticosteroids were administered in six (54.55%) patients. Complete CN recovery was observed in seven (63.63%) patients, while four (36.36%) patients suffered from permanent CN damage—two (18.18%) CN VII, one (9.09%) CN VII and VIII, and one (9.09%) CN VI. Herpes zoster CP presents an interesting diagnostic and therapeutic challenge. Successful management of these patients depends on a thorough knowledge of the anatomy and topodiagnostic of CNs. Early administration of antiviral agents is crucial in terms of responsiveness to treatment and expedite recovery.