scholarly journals A Rare Case of Cranial Polyneuritis as Complication of Ramsay Hunt Syndrome

2019 ◽  
Vol 11 (4) ◽  
pp. 133-136
Author(s):  
Jonathan Kurnia Wijaya ◽  
Hendra Wijaya Wong
Keyword(s):  
Case Report ◽  
Facial Paralysis ◽  
Rare Complication ◽  
Severe Disease ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Delayed Treatment ◽  
Hunt Syndrome ◽  
Classic Triad ◽  
Initial Symptoms

AbstractRamsay Hunt Sydnrome is a rare and severe disease caused by the reactivation of varicella zoster virus (VZV) in the ganglia geniculate. The classic triad of this disease includes ear pain (otalgia), vesicles in the auditory canal, and facial paralysis. This case report is about a 37-year-old woman that has the classic triad of Ramsay Hunt Syndrome, as well as a rare complication of cranial polyneuritis in the form of cephalgia and vertigo which occurs only in 1.8% of cases. The patient came one week after the initial symptoms had started and was given antiviral combination therapy and steroids. Treatment of this disease is time sensitive to <72 hours and will determine the prognosis. One month later the follow up showed sequelae in the form of persistent headache and slight facial paralysis as a result of delayed treatment. This case report showed the importance of prompt diagnosis and treatment to minimize complications of Ramsay Hunt Syndrome.

scholarly journals Ramsay hunt syndrome- expect the unexpected: A case report

2021 ◽  
Vol 7 (3) ◽  
pp. 172-175
Author(s):  
Poorva Saxena ◽  
G. V. Ramachandra Reddy ◽  
Hina Handa ◽  
Ajita Singh
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Neurological Diseases ◽  
Rare Complication ◽  
Varicella Zoster Virus Infection ◽  
Post Herpetic Neuralgia ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Vesicular Rash

Herpes zoster represents a latent reactivation of the varicella zoster virus infection with a dermatomal pattern of eruption and complicated by post-herpetic neuralgia. Ramsay hunt syndrome is a rare complication of herpes zoster and it is not just a syndrome but it's rather an infectious disease. This syndrome is characterized by peripheral facial nerve palsy associated with an erythematous vesicular rash on the ear. It is characterized by unilateral pattern of facial involvement and presence of vesicles helps in early diagnosis and distinguish the syndrome with diseases mimicking other severe neurological diseases. This article reports a case of 56-year-old male patient who reported with a complaint of severe toothache, which serves as severe prodrome for reactivation of herpes zoster virus which later leads to Ramsay Hunt syndrome. This case report highlights about the management of herpes zoster and its complication and emphasizes on prevention of post herpetic neuralgia complication.

scholarly journals Facial paralysis due to Ramsay Hunt syndrome - A rare condition

2017 ◽  
Vol 63 (4) ◽  
pp. 301-302 ◽  
Author(s):  
Aline Lariessy Campos Paiva ◽  
João Luiz Vitorino Araujo ◽  
Vinicius Ricieri Ferraz ◽  
José Carlos Esteves Veiga
Keyword(s):  
Herpes Zoster ◽  
Facial Paralysis ◽  
Rare Complication ◽  
Rare Condition ◽  
Varicella Zoster Virus Infection ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Condition Diagnosis ◽  
Symptoms And Signs

Summary Ramsay Hunt syndrome (or herpes zoster oticus) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion occurs. Usually, there are auricular vesicles and symptoms and signs such otalgia and peripheral facial paralysis. In addition, rarely, a rash around the mouth can be seen. Immunodeficient patients are more susceptible to this condition. Diagnosis is essentially based on symptoms. We report the case of a diabetic female patient who sought the emergency department with a complaint of this rare entity.

scholarly journals Ramsay hunt syndrome- expect the unexpected: A case report

2021 ◽  
Vol 7 (3) ◽  
pp. 172-175
Author(s):  
Poorva Saxena ◽  
G. V. Ramachandra Reddy ◽  
Hina Handa ◽  
Ajita Singh
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Neurological Diseases ◽  
Rare Complication ◽  
Varicella Zoster Virus Infection ◽  
Post Herpetic Neuralgia ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Vesicular Rash

Herpes zoster represents a latent reactivation of the varicella zoster virus infection with a dermatomal pattern of eruption and complicated by post-herpetic neuralgia. Ramsay hunt syndrome is a rare complication of herpes zoster and it is not just a syndrome but it's rather an infectious disease. This syndrome is characterized by peripheral facial nerve palsy associated with an erythematous vesicular rash on the ear. It is characterized by unilateral pattern of facial involvement and presence of vesicles helps in early diagnosis and distinguish the syndrome with diseases mimicking other severe neurological diseases. This article reports a case of 56-year-old male patient who reported with a complaint of severe toothache, which serves as severe prodrome for reactivation of herpes zoster virus which later leads to Ramsay Hunt syndrome. This case report highlights about the management of herpes zoster and its complication and emphasizes on prevention of post herpetic neuralgia complication.

scholarly journals Ramsay Hunt syndrome - a case report

2021 ◽  
Author(s):  
Mateus de Miranda Gauza ◽  
Andréia Canello ◽  
Henrique Muller Genero ◽  
Rafael Marques Mendes ◽  
Maria Francisca Moro Longo ◽  
...  
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Facial Paralysis ◽  
Blurred Vision ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Fluid Analysis ◽  
Peripheral Facial Palsy ◽  
Hunt Syndrome ◽  
The Central Nervous System

Context: Ramsay Hunt syndrome is uncommon, with an incidence of 5 / 100,000 people (1), characterized by the triad of ipsilateral peripheral facial paralysis, otalgia and vesicles in the ear canal and / or auricular pavilion (1,2,3). It results from the reactivation of the Varicella Zoster virus in the geniculate ganglion and may extend to other cranial pairs, causing inflammation, edema and nerve dysfunction (1,3). As the second leading cause of peripheral facial palsy (1), its importance lies in a lower likelihood of recovery with a worse prognosis compared to Bell’s palsy (4). Case report: M.R.S, female, 54 years old, went to the emergency room due to ophthalmological complaints (blurred vision, diplopia, floaters, photophobia), nausea and vomiting, associated with vertigo, headache and facial hypoesthesia on the left. With the worsening of the condition, she was referred to the neurology service of the municipal hospital São José, presenting dysarthria, vesicular lesions in the left external auditory canal, preserved tactile sensitivity, MRC grade V and facial paralysis on the left (House Brackmann grade IV). Lumbar puncture and cerebrospinal fluid analysis were performed to discard other pathologies of the central nervous system. The diagnosis of Ramsay Hunt syndrome was established and treatment with Acyclovir and prednisone was started. After worsening renal function, drug therapy was suspended and venous hydration increased. She continued with improved renal function and was discharged with valacyclovir and corticosteroids. Conclusions: The importance of early diagnosis and treatment is emphasized in order to avoid permanent sequelae of the disease (1,3).

scholarly journals Persistent hemicrania as onset manifestation of Ramsay Hunt Syndrome

2021 ◽  
Author(s):  
Ney Adson Leal II ◽  
Nágila Pereira Mendes ◽  
Caroline Moraes Tapajós Bolzani ◽  
Hilton Mariano da Silva Junior
Keyword(s):  
Case Report ◽  
Facial Paralysis ◽  
Peripheral Facial Paralysis ◽  
Cerebrospinal Fluid Analysis ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Fluid Analysis ◽  
Peripheral Facial Palsy ◽  
Hunt Syndrome ◽  
The Brain

Context: Ramsay Hunt Syndrome (RHS), also named Optic Herpes Zoster is caused by the reactivation of Varicella-Zoster Virus that occurs in the geniculate ganglion. The classic syndrome is composed of vesicular lesions in the ear, ipsilateral otalgia and peripheral facial palsy. The onset of the syndrome with persistent hemicrania is absolutely atypical as a manifestation of RHS. Case report: A 69 year old woman with subacute onset of left exclusive hemicrania in moderate strong intensity without autonomic signs. Eight days after the onset of headache, she presented left peripheral facial paralysis and after 4 days, she noticed the appearance of vesicles in the left ear and pain in swallowing. She has developed nausea with several episodes of vomiting, important imbalance that made impossible gait. On physical examination she presented vesicles in the left ear and oropharynx, left peripheral facial paralysis House Brackmann grade IV, left hypoacusis, nystagmus and vestibular gait. The brain CT and cerebrospinal fluid analysis were normal. The patient has progressive improvement with Acyclovir. Conclusions: Otalgia or even intermediate neuralgia are more frequent painful manifestations of RHS. This case report highlights the need to consider the diagnosis of SRH in patients with persistent hemicrania, even if without initial classic signs of the syndrome.

Herpes zoster-encefalitis: een diagnostische uitdaging bij de geriatrische patiënt

2022 ◽  
Author(s):  
L. Carmans ◽  
C. Van Dessel
Keyword(s):  
Herpes Zoster ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Herpes Encephalitis ◽  
Diagnostic Challenge ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Prevalent Disease ◽  
Vesicular Rash

Herpes zoster encephalitis: a diagnostic challenge in a geriatric patient Reactivation of the varicella zoster virus (VZV) is a prevalent disease and is - in addition to the typical vesicular rash - responsible for rare neurological conditions. Older people form a major group of concern, given the increasing risk of VZV reactivation at a higher age together with a higher risk of complications. Herpes zoster encephalitis is a rare but serious complication which often presents atypically, delaying the diagnostic process. In this article, the medical history of a patient with herpes encephalitis without the typical clinical and biochemical signs of infection is presented. This patient also suffered from Ramsay Hunt syndrome, another rare complication of VZV, characterized by vesicular rash in the ear and ipsilateral peripheral facial paralysis. Both diseases are briefly reviewed and the potential benefits of vaccination are discussed.

scholarly journals Ramsay Hunt Syndrome associated with central nervous system involvement in an adult: a case report

2015 ◽  
Vol 42 (S1) ◽  
pp. S29-S30
Author(s):  
L Chan ◽  
A Cartagena ◽  
SM Hosseini ◽  
A Bombassaro
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Varicella Zoster Virus ◽  
External Auditory Canal ◽  
Facial Palsy ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
The Central Nervous System

Background: Ramsay Hunt Syndrome with cerebellar encephalitis is rare in adult. Case Report: We describe a 55-year-old diabetic female who presented with truncal ataxia, right peripheral facial palsy and right ear pain associated with erythematous vesicular lesions in her external auditory canal. Later, she developed dysmetria, fluctuating diplopia and dysarthria. No facial lesions were identified and lesions were limited to the external auditory canal. Cerebral spinal fluid tested positive for varicella zoster virus polymerase chain reaction. She was diagnosed with Ramsay Hunt Syndrome with spread to the central nervous system and treated with acyclovir intravenous therapy (10 mg/kg every 8 hours). Her facial palsy completely resolved within 48 hours of acyclovir treatment, however, vesicular lesions, imbalance and cerebellar symptoms remained; a tapering course of high dose prednisone was then added.Discussion: Prognosis for facial palsy is poor in Ramsay Hunt Syndrome: Only 10% of patients will have complete resolution of their facial palsy. Improvement of facial palsy may be a good marker for response to treatment. Conclusion: Varicella zoster virus reactivation affecting the central nervous system in adults is rare. Knowledge of Ramsay Hunt syndrome with brainstem and/or cerebellar involvement is important for diagnosis and for consideration of antiviral and prednisone treatment.

Varicella-Zoster Virus Dna Level and Facial Paralysis in Ramsay Hunt Syndrome

2004 ◽  
Vol 113 (9) ◽  
pp. 700-705 ◽  
Author(s):  
Yasushi Furuta ◽  
Hiroshi Aizawa ◽  
Hirofumi Sawa ◽  
Fumio Ohtani ◽  
Satoshi Fukuda
Keyword(s):  
Varicella Zoster Virus ◽  
Facial Paralysis ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome

scholarly journals Pediatric Ramsay Hunt Syndrome: Analysis of Three Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
İmran Aydoğdu ◽  
Enes Ataç ◽  
Ziya Saltürk ◽  
Yavuz Atar ◽  
Erdi Özdemir ◽  
...  
Keyword(s):  
Facial Paralysis ◽  
Careful Examination ◽  
High Dose ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Pediatric Age Group ◽  
Hunt Syndrome ◽  
Initiation Of Therapy ◽  
Physical Findings ◽  
Syndrome Analysis

Ramsay Hunt syndrome (RHS) is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction and is attributed to varicella zoster virus (VZV) infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. The diagnosis is based on history and physical findings. Treatment of RHS uses a combination of high-dose corticosteroids and acyclovir. This paper presents three cases diagnosed as RHS in the pediatric age group in association with the literature review. The aim of this paper is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of RHS.

scholarly journals Brainstem and Cerebellar Involvement in Ramsay Hunt Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Vijay Letchuman ◽  
Charles D. Donohoe
Keyword(s):  
Varicella Zoster Virus ◽  
Facial Paralysis ◽  
Cerebral Peduncle ◽  
Geniculate Ganglion ◽  
Abducens Nucleus ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Intravenous Acyclovir ◽  
Clinical Awareness

We present a case of a 62-year-old Caucasian male with laryngeal cancer and Ramsay Hunt Syndrome otherwise known as herpes zoster oticus due to reactivation of the varicella zoster virus. Classic findings include the triad of ipsilateral facial paralysis, otic pain, and herpetic lesions in the sensory supply of the facial nerve. The common pathogenesis is associated with anterograde axonal reactivation of the varicella zoster virus in the geniculate ganglion. Unique features of our case include retrograde transaxonal spread of the varicella-zoster virus from the geniculate ganglion into the brainstem and cerebellum including involvement of the abducens nucleus, facial nucleus, middle cerebral peduncle, and inferior cerebellar peduncle. This presented as left facial paralysis, left sixth nerve palsy, horizontal diplopia to the left lateral gaze, profound truncal ataxia, and left-sided dysmetria. Clinical awareness that Ramsay Hunt syndrome may also involve the brainstem and cerebellum is critical in evaluating the clinical neurologic findings and expanding the diagnostic workup to include brain magnetic resonance imaging and cerebrospinal fluid analysis, including varicella zoster polymerase chain reaction. Encephalitis requires longer duration administration of high-dose intravenous acyclovir in conjunction with steroids. Delays in treatment are often associated with unsatisfactory outcomes with extensive residual deficits.

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