Ramsay-Hunt Syndrome – a Rare Manifestation of Relatively Frequent Condition

Czech version

Authors: R. Rosoľanka; K. Šimeková
Authors‘ workplace: Klinika infektológie a cestovnej medicíny, JLF UK a UN Martin
Published in: Cesk Slov Neurol N 2016; 79/112(2): 222-224
Category: Case Report

Overview

The Ramsay-Hunt syndrome results from reactivation of the varicella-zoster virus at the geniculate ganglion level. The syndrome is characterized by a combination of peripheral facial paralysis and a herpes-like rash occurring on the face, most commonly in the ear canal and the skin of the external ear, and the possible association with the cochlea-vestibular symptoms. According to the available data, combination of an antiviral therapy with corticosteroids and adequate analgesic therapy remains the gold standard of the treatment of the Ramsay-Hunt sydrome. We present a case of a 55-year-old patient.

Key words:
Ramsay-Hunt syndrome – varicella-zoster virus – facial paralysis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Kennedy PG. Varicella-zoster virus latency in human ganglia. Rev Med Virol 2002;12:327–34.

2. Straube A, Padovan CS. Herpes zoster: velauf, komplikationen und therapie. Nervenartz 1996;67(8):623–9.

3. Wagner G, Klinge H, Sachse MM. Ramsay Hunt syndrome. J Dtsch Dermatol Ges 2012;10:238–43.

4. Hunt JR. On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications. J Nerv Ment Dis 1907;34:73–96.

5. Slivka M. Ramsay-Huntův syndrom. Neurol Prax 2001;3:144–6.

6. Whitley RJ. Chickenpox and Herpes Zoster (Varicella-Zoster Virus). In: Bennett JE, Dolin R, Blaser MJ (eds). Mandell, Douglas, and Bennett´s Principles and Practice of Infectious Diseases. 8th ed. Canada: Elsevier Inc 2015:1731–7.

7. Rupa V, Saunders RL, Weider DJ. Geniculate neuralgia: the surgical management of primary otalgia. J Neurosurg 1991;75(4):505–11.

8. Michal L, Szilágyiová M, Kurča E, et al. Ramsay-Huntov syndróm. Klin Mikrobiol Inf Lék 2003;3:143–5.

9. Malin JP, Weissenborn K, Heinze HJ. Das Ramsay-Hunt-Syndrom. Verhandl Dtsch Ges Neurol 1985;3:658–61.

10. Boemo LR, Navarrete LM, Garcia-Arumi MA, et al. Ramsay Hunt syndrome: our experience. Acta Otorrinolaringol Esp 2010;61(6):418–21. doi: 10.1016/j.otorri.2010.07.004.

11. Rasmussen RE, Lykke E, Toft GJ, et al. Ramsay Hunt syndrome revisited – emphasis on Ramsay Hunt syndrome with multiple cranial nerve involvement. Virol Discov 2014;1:1–7.

12. Vlčková E, Švecová E, Štourač P, et al. PCR diagnostika herpetických virů u pacientů s akutní parézou lícního nervu. Cesk Slov Neurol N 2008;71/107(2):201–5.

13. de Ru JA, van Benthem PP. Combination therapy is preferable for patients with Ramsay Hunt syndrome. Otol Neurotol 2011;32(5):852–5. doi: 10.1097/MAO.0b013e31821a00e5.

14. Hato N, Murakami S, Gyo K. Steroid and antiviral treatment for Bell’s palsy. Lancet 2008;371(9627):1818–20. doi: 10.1016/S0140-6736(08)60776-X.

15. Murakami S, Hato N, Horiuchi J, et al. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Ann Neurol 1997;41(3):353–7.

16. Kinishi M, Amatsu M, Mohri M, et al. Acyclovir improves recovery rate of facial nerve palsy in Ramsay Hunt syndrome. Auris Nasus Larynx 2001;28(3):223–6.

17. Uri N, Greenberg E, Kitsez-Cohen R, et al. Acyclovir in the treatment of Ramsay Hunt syndrome. Otolaryngol Head Neck Surg 2003;129(4):379–81.

18. Coulson S, Croxson GR, Adams R, et al. Prognostic factors in herpes zoster oticus (Ramsay Hunt syndrome). Otol Neurotol 2011;32(6):1025–30. doi: 10.1097/MAO.0b013e3182255727.

19. Uscategui T, Doree C, Chamberlain IJ. Corticosteroids as adjuvant to antiviral treatment in Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008;3:CD006852. doi: 10.1002/14651858.CD006852.pub2.