A case of ramsay hunt syndrome with cranial polyneuropathy

Abstract

Ramsay Hunt syndrome is an infectious disease caused by the varicella zoster virus. It is characterized by the symptoms of facial paralysis, otalgia, and erythematous vesicular rash on the auricle and/or oral cavity. We present a case of a patient with clinical evidence of Ramsay Hunt syndrome involving the cranial nerves VI, VII, and VIII. The patient, a 66-year-old woman, showed left facial palsy associated with vesicular eruptions on her left auricle, impaired gaze to left side, and left hearing loss. Four months after the treatment with systemic steroid and antiviral agents, her all symptoms and signs including facial paralysis and diplopia disappeared.

Keywords: Cranial polyneuropathy; Ramsay Hunt syndrome; Steroid.

Fig. 1

Obvious asymmetry was observed during resting (A), eye closure (B), and smiling (C).

Fig. 2

A: Incomplete abduction of the left eye during attempted left gaze. B: Complete improvement of the left cranial nerve VI palsy is seen 4 months after the combination therapy of steroid and antiviral agents.

Fig. 3

Pure tone audiometry showed sensorineural hearing loss on the patient's left ear.