Herpes zoster oticus

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  • Also know as "Herpes Zoster Oticus"
  • Infection of the auricle with associated facial paralysis usually involving CN VII but may involve CN V.
  • Caused by herpes zoster

Clinical Features

  • Facial pain
  • Errytema and Swelling of auricle
  • Vesicles within external ear canal and on auricle
    • Develop over 3-7 days

Differential Diagnosis


  • History and physical
  • Otoscopy
  • Neuro exam focusing on Cranial nerve, crossed findings, upper and lower motor neuron involvement


  1. Oral analgesia
  2. Antiviral Options[1]
    1. Acyclovir 800mg 5 times a day x 7 days
    2. Famicyclovir 500mg TID x 7 days
    3. Valacyclovir 1000mg TID x 7 days


  • Outpatient PMD followup

See Also


  1. Uscategu T. et al. Antiviral therapy for Ramsay Hunt syndrome in adults. Cochrane Database Syst Rev. 2008