Ramsay Hunt syndrome

Jeon, Younghoon,Lee, Heryim The Korean Dental Society of Anesthsiology 2018 Journal of Dental Anesthesia and Pain Medicine Vol.18 No.6

Ramsay Hunt syndrome is a type of acute herpes zoster, which occurs by reactivation of the varicella-zoster virus at the geniculate ganglion. Clinical presentation of Ramsay Hunt syndrome includes a vesicular rash on the ear (herpes zoster oticus) or in the oral mucosa accompanied by acute peripheral facial nerve paralysis. Other cranial nerves such as V, IX, XI, and XII are often involved. Additional variability of the clinical picture of Ramsay Hunt syndrome is produced by varying patterns of skin involvement explained by individual anastomoses between cranial and cervical nerves. Combination treatment containing anti-viral agents and steroids is recommended for the treatment of Ramsay Hunt syndrome. Additionally, early diagnosis of Ramsay Hunt syndrome is a crucial factor to improve damaged nerves in Ramsay Hunt syndrome, which initiates treatment as soon as possible.

이성대상포진에서 전정기능의 평가

한규철,유정국,김규성 대한평형의학회 2003 Research in Vestibular Science Vol.2 No.2

Ramsay Hunt syndrome 환자에 대한 證例報告

권강,박영환,Kwon, Kang,Park, Young-Hwan 대한한방안이비인후피부과학회 2001 한방안이비인후피부과학회지 Vol.14 No.2

Background: Ramsay Hunt syndrome is a disease that cause faical palsy, ear pain, ear vesicle, tinnitus, hardness of hearing by geniculate ganglion herpes. Ramsay Hunt syndrome could be taken two sides view of herpes zoster and facial palsy. In traditional oriental medicine Ramsay Hunt syndrome could be diagnosed as heat and dryness syndromes. Object: These studies are clinical observations about two Ramsay Hunt syndrome patient cases that is recovered under the treatment by herbal-acupuncture therapy and moxibustion. Methods: For treatment in acute state, acupuncture therapy was used and in convalescent stage, herbal acupuncture therapy and moxibustion therapy were used. For diagnosis system, House-Brackmann system, Yanagihara's system used as diagnosis scales. Result&Conclusion: The results as follows. 1. Generally, to treat Ramsay Hunt syndrome, it is knwon that from invasion of virus to period of first effect a short term bring about good result, but in these two cases, though a long term. considerable effect was braught out. 2. In treating two cases, herbal acupuncture therapys what are called CF, JSD were used. satisfactory results was produced.

Bell`s palsy와 Ramsay Hunt syndrome의 병발 치험 1례

정유선 ( Yu Sun Jung ),신현철 ( Hyeon Cheol Shin ) 대구한의대학교 제한동의학술원 2015 東西醫學 Vol.40 No.3

Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear. It is known that varicella zoster virus causes Ramsay Hunt syndrome. Compared with that of Bell``s palsy, patients with Ramsay Hunt syndrome often have more severe paralysis and less likely to recover completely. This study is a clinical case report that shows the Korean medical treatment has an improving effect on Ramsay Hunt syndrome. In general, herpes zoster and facial palsy occur simultaneously at onset in patients with Ramsay Hunt syndrome. In this case, herpes zoster occurs 14 days after facial palsy. The patient was treated by acupuncture and physiotherapy. It took 63 days for H-B scale to be improved into grade II from grade VI.

Ramsay Hunt 증후군에 관한 임상적 고찰

민성욱 ( Seong Uk Min ),이갑석 ( Kap Sok Li ),원종현 ( Chong Hyun Won ),조소연 ( So Yun Cho ),허창훈 ( Chang Hun Huh ),김범준 ( Beom Joon Kim ),김명남 ( Myeung Nam Kim ),김성은 ( Sung Eun Kim ),김찬웅 ( Chan Woong Kim ),박하나 ( H 대한피부과학회 2007 대한피부과학회지 Vol.45 No.11

Background: Ramsay Hunt syndrome (herpes zoster oticus) is characterized by vesicles on the pinna, otalgia, facial nerve palsy and sensorineural hearing loss. It is not such a common dermatological disease like herpes zoster. However, reactivation of the latent varicella zoster virus causes facial palsy and therapeutic onset is one of the prognostic factors in Ramsay Hunt syndrome. Objective: The aim of this study was to elucidate the epidemiology, the clinical characteristics of Ramsay Hunt syndrome and prognosis according to therapeutic ways. Methods: The 84 cases diagnosed as Ramsay Hunt syndrome from January 2000 to July 2007 were assessed in regard to age, sex, clinical characteristics, electromyography (EMG) results, onset of neurological recovery according to medication and onset of rehabilitation therapy by review of medical records. Results: Ramsay Hunt syndrome consisted 4.7% (84 cases of 1787) of total herpes zoster patients. The ratio of male to female patients was 37:47. Frequency was slightly higher in female patients. The mean age was 62±14.7 and the age distribution was in the range of 26∼87 years. The most common clinical appearance was vesicular eruptions and facical nerve palsy including change in nasolabial fold and location of the lip (73.8%), followed by vesicular eruptions and vestibulocochlear symptoms like tinnitus and vertigo (16.7%), facial nerve palsy and vestibulocochlear symptoms appearing together (9.5%). EMG showed abnormal results in 67.9%. More than one kind of abnormality was commonly observed. The most common abnormal EMG result was fibrillation potential (42.2%), followed by positive sharp wave (31.3%), polyphasia (10.8%), high frequency discharge (8.4%), increased insertional activity (4.8%) and fasciculation (2.5%). There was no significant difference in onset of neurological recovery between acyclovir injections and oral famciclovir or valaciclovir treatment. The patients who had received physical therapy a week after the symptoms had developed, had a faster onset of recovery (2.8 week Vs 4.1 week, p<0.05). Conclusion: This study suggests that antiviral agents of a different kind may not affect recovery onset and earlier rehabilitation therapy seems to be effective in neurological recovery in Ramsay Hunt syndrome. (Korean J Dermatol 2007;45(11):1121∼1126)

Ramsay Hunt Syndrome 1례에 관한 임상적 고찰

최우식,김갑성,이승덕,Choi, Woo-Shik,Kim, Kap-Sung,Lee, Seung-Deok 대한침구의학회 2001 대한침구의학회지 Vol.18 No.1

Background : infection associated with otalgia, herpetic eruptions, facial palsy, trigeminal pain and cochleovestibular dysfunction such as hearing dishubance, tinnitus, vertigo and other symptoms, and is not frequently encountered in otolaryngologic field. And facial paralysis occured by this syndrome is rapid in onset, usually severe in degree, and poor in prognosis. Objectives : To evaluate the Oriental Medicine's treatment and prognosis of Herpes zoster oticus and to classify of peripheral Facial palsy on Oriental Medicine. Methods : Clinical observation and analysis about a case of Ramsay-Hunt syndrome III type was done, who visited Dongguk University Gangnam Hospital. This case is managed by integrated therapy of oriental and western medicine. In oriental medicine, to treate ear pain, heonggae-yeongoetang(荊芥蓮翹湯) was given and to treat herpetic eruption, 8 constitution acupuncture treatement was done. In western medicine, antiviral agent, acyclovir and steroid hormone, prednisolon were treated. Result : About 6 weeks treatment, this case which has worse prognosis than Bell's palsy, was completed cured without any complication. Conclusion : 1. Futher divided classification about non-infectious and infectious facial palsy include "Ramsay Hunt Syndrome" is needed. 2. In acute state, Jeonyohwadan's (纏腰火丹) treatement can be applied, but the difference of invasion part, primary symptom such as ear pain and herpetic eruption is needed another treatment. 3. Ear pain and herpetic eruption can be treated in part of poongyeol(風熱) and subyeol(濕熱). 4. In Acupuncture treatement, Jeonyohwadan's (纏腰火丹) treatement can be applied in acute stage and guanwasa's treatement can be applied in chronic stage. but futher research is needed. 5. This case, Ramsay Hunt Syndrome IlI type, was managed by integrated therapy such as heonggae-yeongoetang(荊芥蓮翹湯), 8 constitution acupuncture treatement, acyclovir and prednisolon and this treatement was good effect.

Improvement of facial asymmetry using high intensity focused ultrasound (HIFU) in a Ramsay Hunt syndrome patient

( Wooseok Jeong ),( Woojung Jin ),( Seunghyun Moon ),( Taekgeun Lee ),( Jongkeun Seo ),( Taegwang Kwon ),( Sookkyung Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Ramsay Hunt syndrome (herpes zoster oticus) is characterized by vesicles on the pinna, otalgia, facial nerve palsy and hearing loss. The most common clinical appearance was vesicular eruptions and facial nerve palsy including change in nasolabial fold and location of the lip. Although early systemic steroid is administered, facial nerve palsy persists in more than 50% of the patients. High intensity focused ultrasound (HIFU) has become one of the most popular non-invasive technologies for skin tightening and face lifting. HIFU is a highly precise medical procedure that delivers high-intensity focused ultrasound to the deeper layers of the skin. A 42-year-old man who had been diagnosed as Ramsay Hunt syndrome 4 years ago presented with facial asymmetry due to left facial palsy. Left eyebrow, left eyelid and left angle of mouth were sagging down. 2 months after a single session of HIFU treatment, left eyebrow and left angle of mouth were lifting. The patient was satisfied with improvement of facial asymmetry. We report the application of HIFU as a treatment tool to the face in a patient with facial asymmetry due to left facial palsy by Ramsay Hunt syndrome.

삼차신경절 침범으로 생각되어진 Ramsay Hunt Syndrome 환자의 치료 증례 −증례보고−

박종민,유승준,박아름,이상묵 대한통증학회 2008 The Korean Journal of Pain Vol.21 No.3

Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed to varicella zoster virus infection in the geniculate ganglion. Ramsay Hunt syndrome accounts for about 10% cases of facial palsy. We report a 46-year-old healthy man developed left side skin vesicles on the face with severe pain. We thought of the trigeminal herpes zoster. He was treated with intravenous acyclovir, and stellate ganglion block daily. Four days later, brain magnetic resonance imaging revealed small areas of enhancement in the seventh cranial nerve and eighth cranial nerve, not in the fifth cranial nerve. Eight days later, the left facial palsy was come. We confirmed him as Ramsay Hunt syndrome. We started steroid therapy immediately. He recovered completely a month later. The patient was improved through the early antiviral therapy, steroid medication and stellate ganglion block. (Korean J Pain 2008; 21: 237-240)

비전형 안진을 보인 급성전정증후군을 동반한 Ramsay Hunt 증후군

강봉희,이용우,김재일 대한평형의학회 2020 Research in Vestibular Science Vol.19 No.1

Ramsay Hunt syndrome is an acquired paralysis of the face specifically caused by a varicella-zoster virus infection in the facial nerve. Other cranial nerves in-cluding vestibulo-cochlear disturbance can be affected. Herein we reported a case of Ramsay Hunt syndrome with atypical vestibular syndrome. Although central vestibular signs including direction changing post head-shaking nystagmus or normal head impulse test are generally meaningful, clinicians need to be careful to interpret them because some findings can be observed not only in cases of central disorders but also in peripheral disorders. Clinical findings such as distinct ear pain and close observation of vesicles are important to diagnose Ramsay Hunt syndrome.

외전신경마비가 동반된 Ramsay-Hunt 증후군

라혜주,박재한 대한평형의학회 2018 Research in Vestibular Science Vol.17 No.3

Ramsay-Hunt syndrome is an infectious disease caused by the varicella zoster virus. It is usually associated with facial and vestibulocochlear nerve palsy, but other cranial nerve dysfunction can be accompanied. We present a 68-year-old woman with abducens nerve palsy associated with Ramsay-Hunt syndrome. She showed abduction limitation of left eye with peripheral facial palsy and vestibulopathy of the left side. Varicella zoster virus polymerase chain reaction of cerebrospinal fluid was positive and internal auditory canal magnetic resonance imaging was revealed enhancement of labyrinthine segment of left facial nerve. Although abducens nerve palsy is uncommon feature of Ramsay-Hunt syndrome, but it can be developed by several different mechanisms.