ANA Discussion Forum

Post-Treatment => Post-Treatment => Topic started by: ramirezjrj on February 09, 2013, 03:16:38 pm

Title: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: ramirezjrj on February 09, 2013, 03:16:38 pm
Have you ever had the Chickenpoxs or been exposed to Chickenpoxs?   The virus that causes chickenpox is called Varicella and it never actually leaves your body but becomes dormant.   

There is research that suggest that the Chickenpox Virus (varicella), can be reactivated with surgery for AN removal and can be part of the reason for delayed post op facial paralysis.  The study showed a decreased incidence of DFP from 25% in the control group to 20% in the drug group who were given Valacycloviar for 7 days.   

 Has anyone been prescribed the antiviral  Valacyclovir for delayed post op facial paralysis?   I had surgery on Jan 3, 2013.  No complications until 1 week post op.    I developed left sided facial paralysis and my left eye lid wont close or blink.   No other symptoms.     My surgeon started me on 1000MG of Valacyclovir 3 x a day for seven days.  He believes that because of my delayed facial paralysis, (1 week post op) that this is a result of the viral reactivation.  I am on day 6 of the medication and I think it is starting to make a difference.  Was just curious if anyone else as been given this treatment and did it make a difference. 

Here is research paper and study.
 
J Neurosurg. 2011 Feb;114(2):375-80. doi: 10.3171/2010.5.JNS091854. Epub 2010 Jun 25.

Prognostic factors for the incidence and recovery of delayed facial nerve palsy after vestibular schwannoma resection.Morton RP, Ackerman PD, Pisansky MT, Krezalek M, Leonetti JP, Raffin MJ, Anderson DE.

Source
Stritch School of Medicine, Maywood, Illinois, USA.[/i]
Title: Re: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: JWW on February 09, 2013, 06:23:53 pm
I do know that being on steroids can makes the facial herpes (type 1) surface.....maybe that happened?

JW
Title: Re: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: ramirezjrj on February 09, 2013, 07:59:43 pm
prob so but I've never had or been exposed to the Herpes virus.   Steroids are more proactive to decrease any post op swelling,  Decadron IV is general rule post op for any potential tumor edema or swelling.   I day I had the facial paralysis they did an MRI  which showed no swelling, hematoma or bleed.   

I keep you posted on the progress.   
Title: Re: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: JWW on February 09, 2013, 08:35:44 pm
If you had Chickenpox (Varicella) then it can morf into Herpes Simplex, Herpes Zoster (aka Shingles).   :-\
Title: Re: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: RichB57 on February 09, 2013, 08:44:50 pm
I also had facial paralysis come on shortly after surgery.  When the surgical fellows came to my room on rounds the first day they asked me to smile, and they seemed very surprised when I did.  I asked why the surprise.  They said the tumor had a lot of involvement with my facial nerve and they thought I would have facial paralysis.  They sent me to a facial nerve specialist at Mass Eye and Ear Infirmary (right next to Mass General where I had my surgery) and she was 99% sure it was due to swelling from all the poking around the facial nerve during the surgery.  I was put on prednisone for a week or two, and she predicted it would resolve in 6 to 8 weeks.  In 6 weeks I started to get some movement back, and by 7 weeks it was totally resolved.  So it could just be swelling.
Title: Re: Valacycloviar used for Delayed Facial Nerve Palsy after VS resection.
Post by: ramirezjrj on February 09, 2013, 09:00:19 pm
Wow that is great news to hear.   Thank you.  The surgeons keep saying that this will resolve because I did not have any paralysis post op.  You really made my  day.   Thanks  :)