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IP Journal of Otorhinolaryngology and Allied Science

Ramsay hunt syndrome - Type II

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Article Type : Case Report

Author Details: Ravneet Ravinder Verma,Ravinder Verma*

Volume : 2

Issue : 2

Online ISSN : 2582-421X

Print ISSN : 2582-4147

Article First Page : 53

Article End Page : 57


Ramsay Hunt syndrome is the second most common cause of facial palsy.
At least three separate neurological syndromes carry the name of Ramsay Hunt syndrome (RHS), their only connection being that they were all first described by James Ramsay Hunt. Ramsay Hunt syndrome (RHS) type 1 is a rare and nebulous entity that has alternatively been called dyssynergia cerebellaris myoclonica, dyssynergia cerebellaris progressiva, dentatorubral degeneration, or Ramsay Hunt cerebellar syndrome.
Ramsay Hunt syndrome (RHS) type 2 is a disorder that is caused by the reactivation of preexisting herpes zoster virus in a nerve cell bundle (the geniculate ganglion). Ramsay Hunt syndrome type III, a less commonly referenced condition, and a neuropathy of the deep palmar branch of the ulnar nerve. Ramsay Hunt Syndrome Type II (RHS) is a rare neurological disorder. This syndrome is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox in children and shingles (herpes zoster) in adults. In cases of Ramsay-Hunt syndrome Type II, previously inactive varicella-zoster virus is reactivated and spreads to affect the facial nerves. The classic Ramsay Hunt syndrome, which always develops after a herpetic infection, also can be associated with vertigo, ipsilateral hearing loss, tinnitus, and facial paresis apart from otalgia. Magnetic resonance imaging (MRI) is a new and important tool for use in diagnosing and investigating diseases affecting the facial nerve. In recent gadolinium-DTPA enhanced MRI (GdMRI) studies it has unequivocally been demonstrated that ipsilateral facial nerve, geniculate ganglion, auditory and vestibular nerves, cochlea and vestibule contrast enhancement is present. A case report of Ramsay Hunt syndrome with cochleo-vestibular involvement is reported and role of Gd-MRI is discussed.

Keywords: VZV-Varicella zoster virus, Ramsay hunt syndrome RHS, Facial palsy, GD MRI.