Ramsay Hunt syndrome

Wagner, Gunnar; Klinge, Harald; Sachse, Michael Max

doi:10.1111/j.1610-0387.2012.07894.x

Cited by 65 publications

(99 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 Corticosteroids may reduce facial palsy and inflammation whereas, acyclovir may reduce the duration of treatment and complications in the eye. 4,6 The recovery from RHS is early when these two drugs are given together than giving individually. Being an antimicrobial agent, acyclovir can work against herpes zoster virus also, when given as orally or parenterally without any variation.…”

Section: Discussionmentioning

confidence: 99%

Ramsay Hunt Syndrome: A Clinical Management Experience from a Secondary Care Public Hospital

Balasubramanian¹,

Haridas²,

Jeyaganeshamoorthi³

et al. 2017

IJOPP

View full text Add to dashboard Cite

Introduction: Ramsay Hunt Syndrome is a rare and severe infection caused by varizella zoster virus. Case: The present case describes the manifestations and treatment strategies followed for a 70-year-old woman who visited to a secondary care hospital, Udhagamandalam. The presence of facial palsy, bell's palsy, difficulty in closing the eyes, otalgia and shingles confirmed Ramsay Hunt Syndrome. The early management with acyclovir and prednisolone had shown improvement in clinical outcome of the patient. However, as a preventive measure, it is essential to undergo immunization with varizella vaccine in elder people in this locality.

show abstract

Section: Discussionmentioning

confidence: 99%

Ramsay Hunt Syndrome: A Clinical Management Experience from a Secondary Care Public Hospital

Balasubramanian¹,

Haridas²,

Jeyaganeshamoorthi³

et al. 2017

IJOPP

View full text Add to dashboard Cite

show abstract

“…Complications include post-herpetic neuralgia and corneal inflammation (Oviedo et al, 2007). An early diagnosis of RHS is important as prognosis of cranial nerve damage (Wagner et al, 2012). Antiviral agents and steroids as a combination therapy improve recovery of facial nerve palsy and other cranial nerve palsies (Kim et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Treatment is controversial, some authors reccomending analgesics and eye lubricants while others suggest corticosteroids in order to lessen the inflammmatory process (Secchi et al, 2000;Alcantara et al, 2000). Studies show that aciclovyr decreases the total duration of disease as well as eye complications (Wagner et al, 2012;Esteves et al, 2010;Secchi et al, 2000). Case report: A 60-year old female patient sought the emergency room of Nova Iguaçu General Hospital due to a complaint of not being able to close her left eye accompanied by a drift of the labial fold to the right as well as a sensation of "burning eyes" for the last three days, but, there was no ear pain.…”

Section: Introductionmentioning

confidence: 99%

Ramsay Hunt Syndrome: Case Report

Silveira¹,

Oliveira²,

Bello³

et al. 2012

American Medical Journal

View full text Add to dashboard Cite

Problem statement: Ramsay Hunt syndrome is characterized by peripheral facial palsy and eruptions in external ear reportedly due to the reactivation of latent varicela zoster virus in the sensory ganglia of facial nerve. Our purpose is to describe a case of this syndrome accompanied by the Neurology Service of Nova Iguacu General Hospital. Approach: A 60-year old female patient sought the emergency room due to a complaint because she was not able to close her left eye, followed by a drift of the labial fold to the right as well as a sensation of "burning eyes" for the last three days. She also referred vertigo and bilateral hypoacusis, more intensely felt on the left side. Results: Physical examination showed a left facial palsy with a vesicular eruption in the left external auditory canal, ear lobe and neck on that side. Her taste sensation was decreased on the anterior 2/3 of the tongue, a negative rinne test, a positive weber test indicating a neurossensorial hearing loss, ataxia in walking, a Romberg sign and an abnormal fukuda pace test, however the CT scan was normal. Conclusion:The diagnosis is basically clinical, in turn, treatment is controversial. In addition to clinical findings, the diagnosis is confirmed by the presence of viral DNA in the involved tissue and vesicular exudate, as assessed by polymerase chain reaction. Ramsay Hunt syndrome involves severe dysfunction, with poorer facial nerve prognosis than in Bell's palsy. Some studies suggest that treatment with prednisone and acyclovir may improve outcome, although a prospective randomised treatment trial remains to be undertaken.

show abstract

“…Suggested antivirals include acyclovir (800 mg, 5 times daily), valacyclovir (1000 mg, 3 times daily) or famcyclovir (500 mg, 3 times daily) for 7-10 days. 2,3 Acyclovir administered intravenously (10 mg/kg every 8 hours for 7 days) is recommended for immunocompromised patients or patients with visceral, disseminated or ocular involvement. 4 Suggested corticosteroid dosing is prednisone, 60 mg daily for 14 days, then tapered over 7 days.…”

mentioning

confidence: 99%

Ramsay Hunt syndrome

Montague

Morton

2017

CMAJ

View full text Add to dashboard Cite

An 83-year-old woman with dementia was admitted to hospital after her caregivers noted a one-week history of increasing confusion, episodic vertigo and difficulty speaking. The day before the patient's admission, she had complained of pain in her left ear, and caretakers noted drooping on the left side of her face.Because of the patient's dementia, taking a reliable history of tinnitus and hearing loss was not possible, and undertaking magnetic resonance imaging was difficult. Left facial droop and mild dysphasia were observed on physical examination, consistent with palsy of the left cranial nerve VII ( Figure 1A; Appendix 1, video available at www.cmaj.ca/lookup/ suppl/doi:10.1503/cmaj.160483/-/DC1). Laboratory investigations and computed tomography imaging were unremarkable. Four days after the patient's admission to hospital, the patient's left ear -unremarkable on admission -had clustered vesicles in the external auditory meatus, coinciding with the distribution of the somatosensory chorda tympani branch of cranial nerve VII ( Figure 1B). We diagnosed herpes zoster oticus (Ramsay Hunt syndrome, type 2).Herpes zoster has an annual incidence of 3.2-4.2 cases per 1000.1 Incidence rises in the fifth decade of life and peaks in the eighth decade.2 Lifetime incidence is estimated at 32%. 1 Facial nerve involvement occurs in only 1% of patients, and predominantly affects women in their fifth and sixth decades. Treatment consists of analgesics, antivirals and corticosteroids. Suggested antivirals include acyclovir (800 mg, 5 times daily), valacyclovir (1000 mg, 3 times daily) or famcyclovir (500 mg, 3 times daily) for 7-10 days.2,3 Acyclovir administered intravenously (10 mg/kg every 8 hours for 7 days) is recommended for immunocompromised patients or patients with visceral, disseminated or ocular involvement.4 Suggested corticosteroid dosing is prednisone, 60 mg daily for 14 days, then tapered over 7 days. 3Efficacy of treatment is time sensitive. If treatment with antivirals and corticosteroids is begun within 3 days, 4-7 days, or more than 8 days, paresis resolves 75%, 48% and 30%, respectively. To prevent herpes zoster, the herpes zoster vaccine is recommended for patients 60 years of age and older. Within the first five years of administration, the vaccine is 51% effective, dropping to 40% effectiveness four to seven years after administration. Currently, data regarding efficacy beyond seven years is lacking. 5Our patient's family decided to focus on her comfort while in hospital and not pursue additional tests and treatment. The nonresolution of the patient's symptoms on follow-up reflected the syndrome's natural history rather than treatment failure. This article has been peer reviewed.The authors have obtained patient consent.Affiliation: Department of Medicine, Queen's University, Kingston, Ont.

show abstract

Ramsay Hunt syndrome

Cited by 65 publications

References 47 publications

Ramsay Hunt Syndrome: A Clinical Management Experience from a Secondary Care Public Hospital

Ramsay Hunt Syndrome: A Clinical Management Experience from a Secondary Care Public Hospital

Ramsay Hunt Syndrome: Case Report

Ramsay Hunt syndrome

Contact Info

Product

Resources

About