Sir.—Herpes zoster oticus (HZO) is characterized by varicella zoster virus (VZV) infection of the ear in association with facial nerve palsy. It may result in permanent facial paralysis and denervation more frequently than does idiopathic Bell's palsy.1 We describe three patients diagnosed with HZO associated with seventh cranial nerve palsy.
Patient Reports.—Patient 1.—A 10-year-old boy reported left ear pain for 4 days and progressive left facial weakness for 3 days before hospitalization. Otitis media had been diagnosed, and antimicrobial treatment had been initiated 7 days earlier. He had had chickenpox at age 4 years. Results of physical examination on admission revealed an afebrile child with infranuclear left facial paralysis. The left tympanic membrane was erythematous; vesicles were seen on the annulus of tympanic membrane and on the external auditory canal of the left ear. Intravenous acyclovir (30 mg/kg of body weight per day) was administered