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[Ramsay Hunt syndrome--differential diagnosis, pathogenesis and therapy]
D Aframian1, R Ben-Oliel, Y Sharav
1Dept. of Oral Diagnosis, Hebrew University-Hadassah School of Dental Medicine, Jerusalem.
Harefuah
|July 29, 2000
Summary
Ramsay Hunt syndrome, a varicella-zoster virus infection, can cause facial palsy and ear pain. Early diagnosis and treatment of this seventh cranial nerve disorder are crucial to prevent permanent nerve damage.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Ramsay Hunt syndrome (RHS) originates from varicella-zoster virus (VZV) infection impacting the geniculate ganglion of the facial nerve (seventh cranial nerve).
- This viral reactivation can lead to a constellation of neurological and dermatological symptoms.
Observation:
- An 82-year-old female presented with acute onset of right-sided facial palsy.
- She also exhibited characteristic auditory canal eruption and otalgia (ear pain).
- Oral examination identified erosive lesions on the anterior two-thirds of the tongue and palate, accompanied by taste disturbance.
Findings:
- The clinical presentation strongly indicated Ramsay Hunt syndrome.
- VZV infection of the facial nerve was confirmed as the etiology.
- The patient experienced facial nerve paralysis, orofacial lesions, and sensory deficits.
Implications:
- Prompt diagnosis of RHS is critical for effective management.
- Early antiviral and corticosteroid therapy can mitigate the risk of irreversible complications.
- Timely intervention improves outcomes for facial nerve function and prevents long-term sequelae.