RAMSAY HUNT SYNDROME WITH MULTIPLE CRANIAL NEUROPATHIES.
Chok Tong KHAW1, Rosdan SALIM2, Julius Liang Chye GOH1, Jothi SHANMUGANATHAN1.
1Department of Otorhinolaryngology, Hospital Sultanah Aminah, 80100 Johor Bahru, Johor, Malaysia.
2Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan & Hospital Universiti Sains Malaysia.
ABSTRACT:
Ramsay Hunt Syndrome (RHS) is a rare type of shingles caused by reactivation of Varicella Zoster Virus(VZV) in the geniculate ganglion hence causing painful vesicular rash at the area of distribution of geniculate ganglion and peripheral cranial nerve(CN) VII palsy. In this syndrome, the involvement of CN VIII is also relatively common causing hearing and balance problems. Nonetheless, despite rare, other cranial nerves such as CN V, IX, X, and XII might also be involved, making the diagnosis of RHS more complicated. The involvement of these nerves may cause physiological impairment leading to serious complications if not managed appropriately. Treatment which consists of steroid and antiviral combination should be commenced as early as possible to achieve the best outcome. Here, we report a rare case of Ramsay Hunt syndrome with multiple cranial nerves involvement and share a brief literature review of similar cases.
Keywords: Ramsay Hunt syndrome (RHS), Cranial nerves, Facial nerve, Vagus nerve, Varicella zoster virus (VZV)
Corresponding author: Khaw Chok Tong(MBBS), Department of Otorhinolaryngology, Hospital Sultanah Aminah, 80100 Johor Bahru, Johor, Malaysia. Email: choktong87@gmail.com. Telephone: +60138181510
Brunei Int Med J. 2021;17:1-5