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안면 신경 마비 환자의 측두골 자기공명영상 소견:벨마비 및 귀 대상포진의 비교
박시내,김현수,정소령,박경호,김범수,곽봉기,박준욱,이석은,여상원 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.7
Background and Objectives:Magnetic resonance imaging (MRI) is a valuable and important tool for use in diagnosing and investigating diseases affecting the facial nerve. However, there are few reports investigating the difference in the MRI findings of Bell’s palsy and Ramsay Hunt syndrome. in order to evaluate the difference in the clinical values regarding these two groups of facial nerve palsy syndrome. In this study, we observed the MRI findings to investigate the value of MRI and its clinical significance in those two different groups of facial nerve palsy. Subjects and Method:Fourty-eight patients of Bell’s palsy or herpes zoster oticus, who were admitted to Kangnam St. Mary’s Hospital from January 1998 to December 2003, were selected to assess the results of gadolinium enhanced MRI. The frequency and the site of the facial nerve enhancement and its correlation with electroneuronography (ENoG), the time interval of the palsy to MRI, and initial ESR levels were observed in both groups of facial nerve palsy. Results:On gadolinium enhanced MRI, 16 of 24 patients with Bell’s palsy and 22 of 24 patients with herpes zoster oticus had contrast enhancement in the meatal, labyrinthine segments and geniculate ganglion. The number of enhanced segments was significantly larger in the patients with herpes zoster oticus than in the patients with Bells palsy (p<0.05). There has been significant correlation between the number of enhanced segment of the facial nerve and the result of ENoG in the patients with herpes zoster oticus (p<0.05). Conclusion:Gadolinium enhanced MRI (Gd-MRI) studies may predict the extent of lesion within the course of the facial nerve and its clinical value as a prognostic factor could be suggested in patients with herpes zoster oticus.
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정다은,김성훈,최승옥,박상유 대한이식학회 2016 Korean Journal of Transplantation Vol.30 No.2
Varicella zoster virus (VZV) infection is due to VZV reactivation in most cases. The infection rate ranges from 4% to 12% in renal allograft recipients. Ramsay Hunt syndrome (RHS) is a rare manifestation of VZV infection. RHS typically presents as severe ear pain, small vesicles, and facial palsy. We reported a case of a 60-year-old man with an unusual clinical course who underwent living donor renal transplantation. He complained of severe ear pain but did not show vesicles or facial palsy. He also presented lesions indicating a fungal infection. Diagnosis of RHS was delayed since facial palsy did not develop until some days later. Although the denervation rate was high, he showed recovery of nearly all symptoms after antiviral treatment. Solid organ recipients may not typically show presentation of viral infection, and therefore clinical suspicion is important. Even though the final diagnosis is delayed, we must treat patients since they may recover well in contrast with the average population.
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HIV 감염 환자에서 발생한 Ramsay Hunt 증후군
강은경 ( Eun Kyung Kang ),김지연 ( Ji Yeon Kim ),송경환 ( Kyung Hwan Song ),문송미 ( Song Mi Moon ),고광필 ( Kwang Pil Ko ),서일혜 ( Yiel Hea Seo ),박윤수 ( Yoon Soo Park ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
Ramsay Hunt syndrome is caused by reactivation of the varicella zoster virus in the geniculate ganglion of the sensory branch in the face and ears. It is characterized by peripheral facial palsy, ear pain, and vesicles in the auditory canal and auricle. We report on a first case of Ramsay Hunt syndrome in a patient with human immunodeficiency virus in Korea. The patient, a 40-year-old male, first presented with otalgia and ear fullness. On admission, he had right facial palsy of the peripheral type, otorrhea, headache, limited tongue movement, and right auricle vesicular eruptions. He had positive human immunodeficiency virus antibody and Western blot tests. His CD4 T cell count was 281/μL. The patient was treated with valacyclovir and steroid with highly active antiretroviral therapy. His symptoms and facial palsy improved with treatment. (Korean J Med 2016;90:169-172)
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