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. 2004 Dec 2;4(1):3.
doi: 10.1186/1472-6815-4-3.

Bilateral Ramsay Hunt syndrome in a diabetic patient

Rajan Syal  1 , Isha Tyagi, Amit Goyal
Affiliations

Bilateral Ramsay Hunt syndrome in a diabetic patient

Rajan Syal et al. BMC Ear Nose Throat Disord. .

Abstract

BACKGROUND: Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. CASE PRESENTATION: Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. CONCLUSIONS: Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

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Figures

Figure 1
Figure 1
Patient at time of presentation, photograph showing bilateral lower motor neuron type of facial palsy and presence of Bell's phenomenon.
Figure 2
Figure 2
Patient after 8 wks of follow up, photograph showing complete closure of eyes.
See this image and copyright information in PMC

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