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- A Case of Ramsay Hunt Syndrome Showing Central Findings due to Brainstem Involvement
- Min Hyuk Lee, Min-Beom Kim
- Res Vestib Sci. 2023;22(4):120-126. Published online December 15, 2023
- DOI: https://doi.org/10.21790/rvs.2023.22.4.120
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Abstract
PDF - Ramsay Hunt syndrome occurs when the varicella zoster virus reactivates. Classic findings include the triad of facial paralysis, otic pain and herpetic lesions due to the pathogenesis associated with anterograde axonal reactivation of the varicella zoster virus in the geniculate ganglion. In addition to the classic triad, rare features such as a central type of vestibular function test may be observed due to the retrograde spread of the varicella zoster virus from the geniculate ganglion into the brain stem, including involvement of the vestibular nucleus. We present a case of Ramsay Hunt syndrome in a 57-year-old male patients, manifesting not only the typical triad of symptoms but also the unique features associated with brain stem involvement. This presented as direction-changing gaze-evoked nystagmus and a decrease in gain on both sides on video head impulse test. And brain magnetic resonance imaging showed a lesion in the vestibular nucleus of the brain stem.
- Atypical Presentation of Acute Vestibular Syndrome with Ramsay Hunt Syndrome
- Bong-Hui Kang, Yong-Woo Lee, Jae-Il Kim
- Res Vestib Sci. 2020;19(1):16-21. Published online March 15, 2020
- DOI: https://doi.org/10.21790/rvs.2020.19.1.16
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Abstract
PDF
- Ramsay Hunt syndrome is an acquired paralysis of the face specifically caused by a varicella-zoster virus infection in the facial nerve. Other cranial nerves including vestibulo-cochlear disturbance can be affected. Herein we reported a case of Ramsay Hunt syndrome with atypical vestibular syndrome. Although central vestibular signs including direction changing post head-shaking nystagmus or normal head impulse test are generally meaningful, clinicians need to be careful to interpret them because some findings can be observed not only in cases of central disorders but also in peripheral disorders. Clinical findings such as distinct ear pain and close observation of vesicles are important to diagnose Ramsay Hunt syndrome.
Original Article
- Evaluation of Vestibular Function in Ramsay Hunt Syndrome
- Gyu Cheol Han, Jung Kook Yoo, Kyu Sung Kim
- J Korean Bal Soc. 2003;2(2):202-205.
- 2,652 View
- 23 Download
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Abstract
PDF
- Background
and Objectives: Ramsay Hunt syndrome is herpes zoster of the facial nerve, frequently associated with VIII cranial nerve involvement, but on rare occasions other cranial nerves are affected as well. We tried to show that Ramsay Hunt symdrome should be recognized as a cranial polyneuropathy characterized by damage to cranial nerves, especially the facial nerve and the auditory-vestibular nerve. Materials and Method: 11patients suffered from auricular vesicles, otalgia, facial palsy, and vertigo. Group A included 8 patients of acute peripheral vestibulopathy with Ramsay Hunt syndrome. Group B included only 3patients of Ramsay Hunt syndrome. Each patient received a battery of tests, including neurological examination, audiometry, vestibular function test.
Results
The lesion site of Ramsay HHhhunt syndrome was right in 5cases and left in 6cases. Electronystagmography showed 3cases of right acute peripheral vestibulopathy, 5cases of left, and 3cases of disequilibrium. Site of Ramsay hunt syndrome and that of vestibulopathy was same in 8cases of Group A. 3cases was observed in Ramsay Hunt syndrome patients that hearing loss and vestibulopathy was same site. Facail nerve palsy improved without recovery of vestibular function. Cranial examination and imaging study like brain CT or temporal MRI showed no abnormal finding.
Conclusion
Although Ramsay Hunt syndrome usually presents with the classical triad of pain, vesicles and facial nerve paralysis, it must be kept in mind that it is a cranial polyneuropathy. In our study, there was few association between facial nerve palsy recovery and acute peripheral vestibulopathy.
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