An extreme and unusual variant of Ramsay Hunt syndrome

Abstract

have communicating branches, by which the VZV could involve multiple cranial nerves. 8 Inflammation and edema of the multiple nerves might play a major role in the course of Ramsay-Hunt syndrome. These might be the reasons for the patient's multiple cranial nerve involvement. Due to the early application of antiviral agents and glucocorticosteroid, or a younger age or the acupuncture and infrared physiotherapy, he recovered faster than many cases in the published work. REFERENCES 1 Hunt JR. On herpetic inflammations of the geniculate ganglion. A new syndrome and its complications. J Nerve Ment Dis 1907; 34 (2): 73-96. 2 Asnis DS, Micic L, Giaccio D. Ramsay Hunt syndrome isherpes zoster of the facial nerve, frequently associated with VIII cranial nerve involvement, but on rare occasions V, VI, IX, and X cranial nerves are affected as well. We present a case of a Ramsay Hunt syndrome with involvement of V, VII, and VIII cranial nerves.

Ramsay Hunt Syndrome With Severe Dysphagia

“…1 Although rare, in some cases, the varicella zoster virus responsible for the illness can also be associated with involvement of cranial nerves III-XII, cervical nerves, aseptic meningitis, and the syndrome of inappropriate secretion of antidiuretic hormone. 2 We present a case of a patient with clinical evidence of Ramsay Hunt syndrome involving the cranial nerves V, VII, VIII, X, and, possibly, XII.…”

Ramsay Hunt syndrome complicated by a brainstem lesion

“…nerves can be affected and cause extraocular movement limitations, facial sensorimotor changes, bulbar dysfunction, and neck weakness (De and Pfleiderer, 1999;Xanthopoulos et al, 2002).…”

Petrositis in Ramsay Hunt Syndrome With Multiple Cranial Neuropathies

“…1 Involvement of additional cranial nerves is a phenomenon that has been recognized since the original clinical description but has received relatively little attention. 2,3 We report a case of a patient with the clinical diagnosis of RHS presenting with multiple cranial neuropathies in whom a magnetic resonance imaging study of the brain demonstrated evidence of petrosal inflammation, a finding previously unsuspected in a condition known to spread through interneural connections.…”

“…However, because imaging studies are not routinely obtained in these patients (where abnormalities are largely restricted to enhancement of the nerve trunks of the seventh and eighth cranial nerves 4 ), it is unclear how common petrosal involvement of a primary geniculate ganglion infection is in the subset of patients with RHS and multiple cranial neuropathies, or whether it may account for the poor antiviral treatment response. 2,3 Although the mechanism of petrosal involvement is unknown, the lack of abducens nerve palsy excludes Gradenigo's syndrome, the only other known disorder in which cranial neuropathy and petrositis coexist. …”