Ramsay hunt syndrome with multiple cranial nerve involvement

Abstract

Ramsay Hunt Syndrome (RHS) is characterized by vesicles in external auditory canal, ear discomfort, and facial nerve palsy in the periphery. RHS which affects multiple cranial nerve involvement has rarely happened. This study is about RHS case that affect right multiple cranial nerves VI, VIII, IX, X. A 46-year old male patient complaint of crust and pain from right ear lobe. There were complaints of decreased hearing ability, tinnitus, difficulty to swallow, double vision, incapability of closing the right eyelid, and a facial slight palsy to the right. Multiple yellowish crusts and erosions were identified. Tzanck and Polymerase Chain Reaction test were not performed. Patient was diagnosed RHS with right multiple cranial nerves VI, VIII, IX, X, received Acyclovir and Prednisone tablets for 7 days. Patient improved. This finding showed that a detailed history taking, physical and additional examinations are required for accurate diagnosis for RHS multiple cranial nerve involvement.