Ramsay Hunt’s Syndrome - a Multidisciplinary Problem

Overview

The author submits a comprehensive view on the problem of Ramsey Hunt’s syndrome. He discusses the history, classification, anatomy, clinical picture, pathogenesis, epidemiology, diagnosis, therapy, course and prognosis of the syndrome.Ramsey Hunt’s syndrome was described in 1907 by the American neurologist James Ramsay Hunt who elaborated the anatomical and clinical classification of the syndrome. The classical Ramsay Hunt’s syndrome is characterized by a triad of symptoms - paresis of the facial nerve, symptoms of vestibulocochlear dysfunction and herpetic vesicles of the external ear. The primary site of the herpes virus is in the area of the motor nucleus of the VIIth nerve or a multifocal localization in the brain is involved. With regard to the possible concomitant affection of several nerves in the head the process is interpreted at present as a cranial polyneuropathy. Ramsay Hunt’s syndrome is rare, it is a disease of more advanced age groups. The diagnosis is based on a typical clinical picture supported by serological examination. The basis of therapy is a combination of systematically administered virostatics and steroids. In the background of the symptoms there may be a neoplasma. The course and prognosis are variable. For assessment of the prognosis of the facial paresis the House-Brack-mann’s scale is used.

Key words:
herpes zoster oticus - Ramsay Hunt’s syndrome - varicella-zoster virus