Facial Nerve Paresis in Ramsay Hunt Syndrome

iltania mince✉
DOI: https://doi.org/10.25077/mka.v46.i12.p1976-1986.2024

Abstract

Introduction: Ramsay Hunt syndrome (SRH) is known as otic herpes zoster or geniculate ganglion herpes zoster, which is a late complication of Varicella-Zoster Virus (VZV) infection, which causes inflammation of the geniculate ganglion of cranial nerve VII. The SRH triad is ipsilateral facial paralysis, otalgia, and vesicular rash. Case Report:28 year old man with complaints of slanted face since 5 days ago. Right ear pain occurred 2 weeks ago, 1 day later a fluid-filled nodule appeared on the right earlobe and right cheek. On physical examination, yellowish crusts were found on the right side of the face, the auris dextra showed erythema and crusting in the turbinate and antihelix regions. In the Schirmer test the ratio of right and left tears is > 50%, the acoustic reflex is right (-) left (+). The patient was diagnosed with House-Brackmann grade III peripheral facial nerve paresis, good motor function 70% at the level of the geniculate ganglion et causaRamsay Hunt syndrome. Patients are given antiviral therapy, high doses of corticosteroids tapering offand physiotherapy. Conclusion: Management of patients with Ramsay Hunt syndrome by administering antivirals, high doses of corticosteroids, physiotherapy and rehabilitation.

Keywords: ramsay hunt syndrome, varicella zoster virus, herpes zoster oticus

Keywords

ramsay hunt syndrome, varicella zoster virus, herpes zoster oticus

Full Text:

PDF

References

Dhingra P, Dhingra S. Facial Nerve and its Disorders. In: Diseases of Ear, Nose and Throat-EBook. india: Elsevier; 2018. p. 105.

Skillbeck C, Standring S. Facial Nerve and its Non-neoplatic Disorder. In: Watkinson J, Clarke R, editors. Scott-Brown’s Otothinolaryngology Head and Neck Surgery. 8th ed. London: CRC Press; 2018. p. 1402–9.

Mattox D, Vivas E. Clinical Disorder of Facial. In: Flint P, Francis W, editors. Cummings. 7th ed. Philadelphia: Elsevier; 2020. p. 2592–3.

Wackym A, Rhee J. Facial Paralysis. In: Wackym P, Snow J, editors. I8th ed. USA: People’s Medical Publishing House; 2016. p. 445–7.

Vrabec J, Lin J. Acute Paralysis of Facial Nerve. In: Johnson J, Rosen C, editors. Bailey’s Head and Neck Surgery Otolaryngology. 5th ed. Philadelphia: Wolters Kluwer Health; 2014. p. 2512–3.

Inagaki A, Minakata T, Katsumi S, Murakami S. Journal of the Neurological Sciences Concurrent treatment with intratympanic dexamethasone improves facial nerve recovery in Ramsay Hunt syndrome. J Neurol Sci. 2020;410(December 2019):116678.

Harbecke R, Jensen NJ, Depledge DP, Johnson GR, Ashbaugh ME, Schmid DS, et al. Recurrent herpes zoster in the Shingles Prevention Study : Are second episodes caused by the same varicella-zoster virus strain ? Vaccine. 2019;1–8.

Kumai Y, Ise M, Miyamaru S, Orita Y. Delayed transmastoid facial nerve decompression surgery in patients with Ramsay-Hunt syndrome presenting with neurophysiologically complete paralysis. Acta Otolaryngol. 2018;0(0):1–5.

Syndrome RH. A High Neutrophil-to-Lymphocyte Ratio Is Associated with Recovery from. 2019;702:130–7.

Costello F. Cranial Neuropathies and COVID-19: Neurotropism and Autoimmunity. 2020;4–11.

Gonzalez J, Elkin R. Ramsay Hunt Syndrome with Multiple Cranial Neuropathy in an Human Immunodeficiency Virus ( HIV ) Patient. 2018;68–71.

Escalante DA, Malka RE, Wilson AG, Nygren ZS, Radcliffe KA, Ruhl DS, et al. Determining the Prognosis of Bell’s Palsy Based on Severity at Presentation and Electroneuronography. 2020;1–7.

Kim TH. Role of Biomarkers as Prognostic Factors in Acute Peripheral Facial Palsy. 2022;23:1–21.

Rajati M, Zarringhalam MA. Ramsay Hunt Syndrome Associated with True Vocal Cord Palsy- A Case Report. 2019;3(10):2–5.

Kim SJ, Lee HY. Hematological Findings in Patients with Acute Peripheral Facial Palsy. 2020;16(3):382–6.

Turab M Al, Chehadeh W. Varicella infection in the Middle East : Prevalence , complications , and vaccination. 2018;1–12.

Oya ÃR, Takenaka Y, Imai ÃT, Sato ÃT, Oshima ÃK, Ohta ÃY, et al. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Hematologic Markers of Bell ’ s Palsy : A Meta-analysis. 2019;40:681–7.

Report C, Ozer F. Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With. 2021;6–11.

Rafferty E, Mcdonald W, Qian W, Osgood ND, Doroshenko A. Evaluation of the effect of chickenpox vaccination on shingles epidemiology using agent-based modeling. 2018;1–27.

Sommer T, Karsy M, Driscoll MJ, Randy L. Varicella Zoster Virus Infection and Osteomyelitis of the Skull: A Case Report. World Neurosurg. 2018;1–12.

Outcomes M, Evidence LOF. Masseteric-to-Facial Nerve Transfer and Selective Neurectomy for Rehabilitation of the Synkinetic Smile. 2019;98431:1–7.



Bookmark and Share
-->