HERPES zoster affecting the head, especially auricular herpes zoster (herpes zoster oticus), is often associated with facial paralysis and lesions of the eighth nerve. Herpes zoster of the outer ear, combined with lesions of the seventh or the eighth cranial nerve or both, is generally called Hunt's syndrome. Hunt1 discussed this syndrome in a series of papers. In connection with these studies, he suggested that the geniculate ganglion might be the origin of sensory fibers in the facial nerve, a theory which has received anatomic support. According to Hunt, the "geniculate area" would comprise the concha and certain other parts of the auricle, part of the external auditory meatus and some "remnants of the geniculate visceral sensory system" on the palate and tongue. Herpetic infection of the geniculate ganglion would produce vesicles in exactly this area. Although there is still no definite histopathologic evidence of the existence of herpetic lesions of the geniculate ganglion in cases of herpes zoster oticus, it has been generally accepted that this type of herpes zoster is caused by microscopic lesions affecting the geniculate ganglion.The facial palsy and the lesions of the eighth nerve often associated with herpes zoster oticus are easily explained by assuming an increased pressure of the swollen geniculate ganglion on the facial nerve or exten¬ sion of the infection to the facial or the auditory nerve. Simultaneous infection of the ganglia of the inner ear has also been suggested.Facial paralysis and lesions of the eighth nerve associated with herpes zoster in the trigeminal or the cervical areas of the head, how-From the Otological Department of the Sabbatsberg Hospital, and the Neurological
