Ramsay Hunt syndrome in children

Hato, Naohito; Kisaki, Hisanobu; Honda, Nobumitsu; Gyo, Kiyofumi; Murakami, Shingo; Yanagihara, Naoaki

doi:10.1002/1531-8249(200008)48:2<254::aid-ana17>3.0.co;2-v

Cited by 87 publications

(33 citation statements)

References 13 publications

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“…The acute peripheral facial paralysis is characterized by vestibulocochlear dysfunction and a herpetic rash around the ear pinna and outer ear canal. It is reported to be the cause of 2-10% of acute peripheral facial paralysis cases [6]. The reported incidence of VZV reactivation is higher in children 6-15 years of age than in younger children [7].…”

Section: Discussionmentioning

confidence: 99%

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A 4-year-old girl presenting with facial palsy, found to have increased delta neutrophil index, and diagnosed with acute myeloid leukemia with extramedullary infiltration

Yoon¹,

Kim²,

Lee³

et al. 2017

Pediatr Emerg Med J

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Ramsay Hunt syndrome (RHS) is characterized by facial paralysis, inner ear dysfunction, periauricular pain, and herpetiform vesicles. The reported incidence in children is 2.7/100,000. The pathogenesis involves the reactivation of latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. The recovery rate is better in children than in adults. This paper discusses a 12-year-old girl with a rare case of peripheral facial paralysis caused by RHS and reviews the literature.

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Section: Discussionmentioning

confidence: 99%

“…Furuta et al reported a lower rate of recovery in RHS versus Bell's palsy (73% versus 100%) [7]. The prognosis for RHS in children is better than that in adults [6]. Audiovestibular findings, presentation including advanced facial paralysis, and starting treatment late result in a bad prognosis [5].…”

Section: Discussionmentioning

confidence: 99%

A 4-year-old girl presenting with facial palsy, found to have increased delta neutrophil index, and diagnosed with acute myeloid leukemia with extramedullary infiltration

Yoon¹,

Kim²,

Lee³

et al. 2017

Pediatr Emerg Med J

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“…From the above epidemiological data it can be estimated that with 300.000 herpes zoster cases nationwide, a proportion of herpes zoster oticus of 1 % and a frequency of peripheral facial nerve paresis in herpes zoster oticus of about 96 %, about 2 700 patients aged 50 years and older develop RHS annually in Germany. Cases of RHS have also been reported in children [19].…”

Section: Epidemiologymentioning

confidence: 97%

“…Subjectively, patients describe a burning or numb sensation in the involved mucosal areas [20,22]. In individual cases zoster sine herpete has been reported in the area innervated by the facial nerve [23,24]. When cutaneous signs and symptoms are lacking, the diagnosis can only be made using serological or molecular genetic methods.…”

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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“…Incidence of HZ and post-herpetic pain reduced with more than 50% as part of their childrens vaccination programme and the incidence of chickenpox, herpes zoster (HZ) and sequelae has declined significantly [6,40,41]. In persons 60 years of age or older, a reduction in incidence of HZ and post-herpetic pain of more than 50% has been shown to be achievable by vaccination [42].…”

Section: Introduction Of Varicella Zoster Vaccinementioning

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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Ramsay Hunt syndrome in children

Cited by 87 publications

References 13 publications

A 4-year-old girl presenting with facial palsy, found to have increased delta neutrophil index, and diagnosed with acute myeloid leukemia with extramedullary infiltration

A 4-year-old girl presenting with facial palsy, found to have increased delta neutrophil index, and diagnosed with acute myeloid leukemia with extramedullary infiltration

Ramsay Hunt syndrome

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

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