Ramsay hunt syndrome: A cranial polyneuropathy

Aviel, Aharon; Marshak, Gabriel

doi:10.1016/s0196-0709(82)80035-5

Cited by 60 publications

(33 citation statements)

References 36 publications

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“…Following the facial nerve, the (descending) order of frequency of involvement of the other cranial nerves is VIII, IX, V, and X. 4 The rash of RHS is herpes zoster caused by the varicella-zoster virus. The rash develops on and around the ear (including the mastoid) and also can involve the face, neck, shoulders, tongue, buccal mucosa, palate, uvula, and larynx.…”

Section: History Of Present Illnessmentioning

confidence: 99%

Facial Weakness and Rash

Birinyi

1996

Academic Emergency Medicine

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Section: History Of Present Illnessmentioning

confidence: 99%

Facial Weakness and Rash

Birinyi

1996

Academic Emergency Medicine

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“…Since RHS is a relatively rare condition, not much epidemiological data is available on which cranial nerves are most commonly affected ( Table 2). The occurrence rate of associated cranial polyneuropathy has been reported to be 1.8-3.2% [5,10,11]. We gathered information on the involvement of cranial nerves from case reports published from 2003 to 2013 on immunocompetent adults ( Table 3) .…”

Section: General Data and Incidencementioning

confidence: 99%

“…Pain in the affected area develops prior to a vesicular rash in 14-50% of VZV patients; the pain may mimic acute otitis and other ear diseases [6,39]. Furthermore, facial nerve palsy might develop several days before the rash in up to 20% of RHS patients [11,39]. More than half the patients have pain as their first symptom while as few as 2% have a rash as the initial symptom [39].…”

Section: Clinical Presentationmentioning

confidence: 99%

Ramsay Hunt syndrome revisited–emphasis on Ramsay Hunt syndrome with multiple cranial nerve involvement

Rasmussen¹,

Lykke²,

Toft³

et al. 2014

Virol Discov

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Introduction: The Ramsay Hunt syndrome is characterized by herpetic lesions combined with peripheral facial nerve palsy. The disease is caused by a reactivation of the varicella zoster virus and can be deceiving since the herpetic lesions are not always present (zoster sine herpete) and might mimic other severe neurological illnesses. This article reviews the various forms of Ramsay Hunt syndrome and how they can give rise to diagnostic and therapeutic challenges. Material and method: Studies on the assessment and treatment of Ramsay Hunt syndrome were found by conducting a thorough literature search in PubMed, Medline, The Cochrane Library database and Google Scholar using the search words «varicella», «zoster», «ramsay hunt», «oticus», «cranial nerve», «facial nerve» and combinations thereof. The bibliographies of substantial articles were subsequently assessed. Results: About 12% of all peripheral facial nerve palsies are caused by varicella zoster virus. In more than 50% pain is the initial symptom making the diagnosis difficult. Female gender, and in general age above 50 years, renders patients more susceptible to Ramsay Hunt syndrome. The main prognostic factor is the severity of the initial symptoms. The occurrence rate of associated cranial polyneuropathy has been reported to be 1.8-3.2% and cranial nerves VII, VIII, IX are the ones most commonly affected. The full recovery rate is reported to be as low as 27.3% when multiple cranial nerves are involved. Combination therapy comprising of antiviral drugs and corticosteroids is recommened and should be initiated within 72 hours. Vaccination against varicella zoster virus is an interesting new development that might reduce the incidence of varicella zoster virus associated disease altogether. Conclusion: Ramsay Hunt syndrome is a difficult and severe diagnosis with a low full recovery rate. Extensive randomized trials are urgently needed to verify the optimal treatment and the efficacy of varicella zoster virus vaccine in both naïve and herpes zoster patients.

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“…Clinical symptoms of abducens nerve paresis manifests as motility disturbances of the eye with double vision, while paresis of the glossopharyngeal nerve and the vagus nerve lead to swallowing and taste disturbances or to vasovagal reactions, e. g. cardiac arrhythmia [8,18,[30][31][32]. Involvement of the optic nerve is considered a rare manifestation of RHS, which can manifest clinically as impaired vision [33]. In the event of intracerebral spread of the infection herpes zoster-associated encephalitis is possible that can in RHS be associated with hemiparesis, hemihypesthesia or dysmetria [34][35][36][37].…”

Section: Clinical Findingsmentioning

confidence: 99%

Ramsay Hunt syndrome

Wagner

Klinge

Sachse

2012

J Deutsche Derma Gesell

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Keywords• herpes zoster oticus • zoster sine herpete • facial palsy • cranial nerve lesions • acyclovir-corticosteroid therapy SummaryRamsay Hunt syndrome is defined as herpes zoster oticus associated with an acute peripheral facial nerve paresis and quite often with other cranial nerve lesions. The combination of motor, sensory and autonomic involvement leads to a variety of neurological damage patterns, i. e. facial muscle paresis, hearing and balance disorders, sensory problems and disturbances of taste as well as lacrimal and nasal secretion. Additional variability of the clinical picture of Ramsay Hunt syndrome is produced by varying patterns of skin involvement explained by individual anastomoses between cranial and cervical nerves. Knowledge of these findings and an early diagnosis of Ramsay Hunt syndrome are important as prognosis of cranial nerve damage depends on the time at which acyclovir-corticosteroid therapy is started.

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Ramsay hunt syndrome: A cranial polyneuropathy

Cited by 60 publications

References 36 publications

Facial Weakness and Rash

Facial Weakness and Rash

Ramsay Hunt syndrome revisited–emphasis on Ramsay Hunt syndrome with multiple cranial nerve involvement

Ramsay Hunt syndrome

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