The experience of using sodium aminodihydrophthalazinedione in the complex treatment of a patient with Ramsey – Hunt syndrome

Abstract

Ramsey-Hunt syndrome is a rather complex interdisciplinary problem for diagnosis and treatment. Often, diagnosis requires the participation of different specialists: otorhinolaryngologists, neurologists, infectionists. Classic manifestations are quite typical (vesicular rash on the skin of the outer ear, on the eardrum, ear pain and lesion of the mimic muscles as a result of peripheral facial nerve paralysis). However, Hunt himself described various variants of pathological changes of the outer ear and pharynx in combination with lesions of the trigeminal, vestibule-cochlear, glossopharyngeal, abducens and vague nerves. The optic nerve is rarely involved, viral encephalitis and vasculitis of the brain may develop. The literature cites traditional treatment schemes that include a combination of antiviral and glucocorticosteroid drugs. However, the duration of the therapy, specific doses of the drugs continue to be discussed. Untimely initiation of antiviral and corticosteroid therapy and/or inadequately selected dosages provoke the progression of the disease, increase the risk of complications and adverse outcomes. The prognosis gets worse when combined with another pathology (diabetes mellitus, oncopathology, HIV infection). Therefore, the search of new Ramsey-Hunt syndrome’s methods and treatment regimens is essential. We have previously described the use of photodynamic therapy in the treatment of this pathology in a patient with a first-time revealed HIV infection. On our opinion, taking into account the herpes-viral etiology of the disease, drugs that have immunomodulatory effect, a protective effect on the affected tissues, regulating the intensity of inflammatory response, can be applied in the therapy of this pathology. The use of the immunomodulatory drug sodium aminodihydrophthalazinedione in complex therapy, especially in patients with a history of aggravating factors, can increase the effectiveness of treatment and reduce the risk of recurrence.